WO2012083280A1 - Provisional tibial prosthesis system - Google Patents

Provisional tibial prosthesis system Download PDF

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Publication number
WO2012083280A1
WO2012083280A1 PCT/US2011/065683 US2011065683W WO2012083280A1 WO 2012083280 A1 WO2012083280 A1 WO 2012083280A1 US 2011065683 W US2011065683 W US 2011065683W WO 2012083280 A1 WO2012083280 A1 WO 2012083280A1
Authority
WO
WIPO (PCT)
Prior art keywords
tibial
shim
bearing component
component
base plate
Prior art date
Application number
PCT/US2011/065683
Other languages
French (fr)
Inventor
Jody L. Claypool
Steven E. Stump
Original Assignee
Zimmer, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Zimmer, Inc. filed Critical Zimmer, Inc.
Priority to EP11808493.8A priority Critical patent/EP2651343B1/en
Priority to ES11808493.8T priority patent/ES2622842T3/en
Priority to CN201180067430.XA priority patent/CN103379880B/en
Priority to AU2011343440A priority patent/AU2011343440B2/en
Priority to EP17157909.7A priority patent/EP3335674B1/en
Priority to CA2824527A priority patent/CA2824527C/en
Priority to JP2013544858A priority patent/JP5559437B2/en
Publication of WO2012083280A1 publication Critical patent/WO2012083280A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4684Trial or dummy prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/103Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes
    • A61B5/1036Measuring load distribution, e.g. podologic studies
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/30721Accessories
    • A61F2/30734Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/3868Joints for elbows or knees with sliding tibial bearing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/38Joints for elbows or knees
    • A61F2/389Tibial components
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2/46Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/461Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of knees
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30329Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30405Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves
    • A61F2002/3042Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by screwing complementary threads machined on the parts themselves with a pin cooperating with a helical groove
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30537Special structural features of bone or joint prostheses not otherwise provided for adjustable
    • A61F2002/30556Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting thickness
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/30Joints
    • A61F2002/30001Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30599Special structural features of bone or joint prostheses not otherwise provided for stackable

Definitions

  • the present disclosure relates generally to provisional orthopedic components used to replicate final orthopedic components during a surgical procedure. More particularly, the present disclosure relates to provisional tibial components that assist in determining the proper size of a final tibial prosthesis for a prosthetic knee joint for replacement of all or part of a natural knee.
  • Knee replacement provisional components are positioned on a distal femur and/or a proximal tibia to allow range of motion testing so that a surgeon can verify proper sizing of final prosthetic components.
  • Knee replacement systems may include a wide variety of tibial bearing components, including bearing components which cooperate to form a posterior stabilized prosthesis, a cruciate retaining knee prosthesis or a knee prosthesis having an intermediate level of constraint between a posterior stabilized and cruciate retaining prosthesis.
  • Such systems include a high number of provisional components corresponding to the differing constraint levels offered by the system as well as the different sized bearings for each constraint level.
  • a surgeon may remove and replace a provisional tibial bearing component of a first size with a provisional tibial bearing component of a second size to adjust the ligament tension of the knee joint.
  • Efforts have been made to lessen the number of provisional components needed during knee surgery, including the use of adjustable tibial components having an adjustable height to allow the adjustable tibial component to mimic a variety of different sized final tibial prostheses.
  • One such device includes a spacer block positioned between a provisional bearing component and a tibial tray to provide additional spacing of the provisional bearing from the tibial tray.
  • these devices require distraction of the knee joint to secure the spacer block to the bearing component and the tibia tray.
  • the present disclosure provides a provisional tibial prosthesis system for a set of prosthetic knee joints for implantation in a natural knee, the provisional tibial prosthesis system including a bearing component and a bearing support, the spacing of the bearing component from the bearing support is adjustable to allow for representation of a variety of different sized final tibial prostheses.
  • a bearing surface that articulates with a femoral prosthesis component.
  • Knee replacement systems may include a wide variety of bearing components, including bearing components which cooperate to form a posterior stabilized prosthesis, a cruciate retaining knee prosthesis or a knee prosthesis having an intermediate level of constraint between a posterior stabilized and cruciate retaining prosthesis.
  • bearing components which cooperate to form a posterior stabilized prosthesis, a cruciate retaining knee prosthesis or a knee prosthesis having an intermediate level of constraint between a posterior stabilized and cruciate retaining prosthesis.
  • only one provisional bearing component corresponding to each level of constraint is needed and shims are used to adjust the spacing of the bearing component from the bearing support.
  • the number of provisional components needed during knee surgery is reduced and adjustment of the system only requires the knee joint to be distracted by a distance equal to the height of a particular shim.
  • the present disclosure includes a plurality of shims slidably insertable between a bearing component and a bearing support in an anterior/posterior direction to allow for adjustment of the spacing of the bearing component from the bearing support.
  • the present disclosure provides a provisional tibial prosthesis system which can be adjusted without removing the bearing component and the bearing support from the knee joint and only distracting the knee joint a distance equal to the height of a particular shim.
  • the shims are available in a variety of heights to vary the spacing of the bearing component from the bearing support. In other embodiments, the shims are available in equal heights for shim stacking.
  • a surgeon can space a bearing component having a bearing component height from a bearing support by sliding a first shim having a first shim height between the bearing component and the bearing support in the anterior/posterior direction, and subsequently perform range of motion testing of the knee joint to verify proper sizing of the provisional tibial prosthesis system. If the provisional tibial prosthesis system is properly sized with the first shim between the bearing component and the bearing support, a first final tibial prosthesis represented by the first shim height and the bearing height can be selected for implantation in the natural knee.
  • the surgeon can remove the first shim from between the bearing component and the bearing support in the anterior/posterior direction, and space the bearing component from the bearing support by sliding a second shim having a second shim height between the bearing component and the bearing support in the anterior/posterior direction. If the provisional tibial prosthesis system is properly sized with the second shim between the bearing component and the bearing support, a second final tibial prosthesis represented by the second shim height and the bearing height can be selected for implantation in the natural knee.
  • a second shim having a second shim height can be used to space the bearing component from the bearing support by sliding the second shim between the bearing component and the bearing support in the anterior/posterior direction with the first shim also between the bearing component and the bearing support. If the provisional tibial prosthesis system is properly sized with the first shim and the second shim between the bearing component and the bearing support, a third final tibial prosthesis represented by the first shim height, the second shim height, and the bearing height can be selected for implantation in the natural knee. This stacking of the shims can be repeated using a variety of shims having equal or varying height.
  • the disclosure in one form thereof, comprises a provisional tibial prosthesis system for a prosthetic knee joint for implantation in a natural knee, the provisional tibial prosthesis system capable of alternatively mimicking the geometry of a first final tibial prosthesis and a second final tibial prosthesis, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the provisional tibial prosthesis system including a tibial base plate having a bone contacting surface and an opposing base plate superior surface; a tibial bearing component having a
  • the disclosure in another form thereof, comprises a provisional tibial prosthesis system for a prosthetic knee joint for implantation in a natural knee, the provisional tibial prosthesis system capable of alternatively mimicking the geometry of a first final tibial prosthesis, a second final tibial prosthesis, and a third final tibial prosthesis, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an
  • the provisional tibial prosthesis system including a tibial base plate having a bone contacting surface and an opposing base plate superior surface; a tibial bearing component having a tibial bearing component height, the tibial bearing component attachable to the tibial base plate, the tibial bearing component height representing the first final tibial prosthesis; a first shim having a first shim height, the first shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/pos
  • the disclosure in a further form thereof, comprises a method of determining a size of a final tibial prosthesis for a prosthetic knee joint for implantation in a natural knee, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the method including: selecting a provisional tibial prosthesis system including a tibial base plate having a bone contacting surface and an opposing base plate superior surface; a tibial bearing component having a tibial bearing component height, the tibial bearing component attachable to the tibial base plate
  • FIG. 1 is an exploded perspective view of a provisional tibial prosthesis system in accordance with an exemplary first embodiment of the present disclosure
  • Fig. 2A is a plan view of a tibial bearing component of the provisional tibial prosthesis system of Fig. 1;
  • Fig. 2B is a front elevation view of the tibial bearing component of Fig. 2A;
  • Fig. 2C is a bottom view of the tibial bearing component of Fig. 2A;
  • Fig. 2D is a cross-sectional view taken along line 2D-2D of Fig. 2A;
  • Fig. 3A is a plan view of a base component of the provisional tibial prosthesis system of Fig. 1;
  • Fig. 3B is a front elevation view of the base component of Fig. 3 A;
  • Fig. 3C is a side elevation view of the base component of Fig. 3 A;
  • Fig. 4A is a plan view of a shim of the provisional tibial prosthesis system of Fig. 1 ;
  • Fig. 4B is a front elevation view of the shim of Fig. 4A;
  • Fig. 4C is a cross-sectional view taken along line 4C-4C of Fig. 4A;
  • Fig. 5 is a perspective view of a tibial base plate of the provisional tibial prosthesis system of Fig. 1;
  • FIG. 6 is a perspective view of a knee joint and the provisional tibial prosthesis system of Fig. 1 illustrating a resected proximal tibia surface with the tibial base plate of Fig. 5 attached thereon, the base component of Fig. 3 A positioned on the tibial base plate, the tibial bearing component of Fig. 2A attached to the base component, and a surgical instrument connected to the shim of Fig. 4A, and illustrating axes of the knee joint;
  • Fig. 7 is a perspective view of the provisional tibial prosthesis system of Fig. 6 illustrating using the surgical instrument of Fig. 6 to slide the shim between the base component and the tibial bearing component in an anterior/posterior direction;
  • Fig. 8 is a perspective view of the provisional tibial prosthesis system of Fig. 6 illustrating the shim between the base component and the tibial bearing component;
  • FIG. 9 is an exploded view of a provisional tibial prosthesis system in accordance with an exemplary second embodiment of the present disclosure.
  • FIG. 10A is a plan view of a provisional tibial prosthesis system in accordance with an exemplary third embodiment of the present disclosure
  • Fig. 10B is a cross-sectional view taken along line 10B-10B of Fig. 10A;
  • Fig. IOC is a cross-sectional view taken along line IOC- IOC of Fig. 10A;
  • FIG. 11 A is a plan view of a provisional tibial prosthesis system in accordance with an exemplary fourth embodiment of the present disclosure
  • Fig. 1 IB is a front elevation view of the provisional tibial prosthesis system of Fig. 11 A;
  • Fig. 12A is an exploded view of a provisional tibial prosthesis system in accordance with an exemplary fifth embodiment of the present disclosure
  • Fig. 12B is a front elevation view of the provisional tibial prosthesis system of Fig. 12A;
  • Fig. 12C is a cross-sectional view taken along line 12C-12C of Fig. 12B;
  • FIG. 13A is a plan view of a provisional tibial prosthesis system in accordance with an exemplary sixth embodiment of the present disclosure
  • Fig. 13B is a cross-sectional view taken along line 13B-13B of Fig. 13 A;
  • FIG. 14 is a partial perspective view of a provisional tibial prosthesis system in accordance with an exemplary seventh embodiment of the present disclosure
  • FIG. 15 is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary eighth embodiment of the present disclosure.
  • FIG. 16A is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary ninth embodiment of the present disclosure
  • Fig. 16B is a plan view of the provisional tibial prosthesis system of Fig. 16A;
  • Fig. 16C is a cross-sectional view taken along line 16C-16C of Fig. 16B;
  • FIG. 17A is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary tenth embodiment of the present disclosure
  • Fig. 17B is a cross-sectional view taken along line 17B-17B of Fig. 17A;
  • Fig. 17C is a cross-sectional view taken along line 17C-17C of Fig. 17A;
  • FIG. 18A is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary eleventh embodiment of the present disclosure
  • Fig. 18B is a partial cross-sectional view taken along line 18B-18B of Fig. 18 A;
  • Fig. 19A is a plan view of a tibial bearing component in accordance with another exemplary embodiment of the present disclosure.
  • Fig. 19B is a front elevation view of the tibial bearing component of Fig. 19A;
  • Fig. 19C is a plan view of a shim in accordance with another exemplary embodiment of the present disclosure;
  • Fig. 19D is a front elevation view of the shim of Fig. 19C.
  • Fig. 19E is a cross-sectional view taken along line 19E-19E of Fig. 19A illustrating the shim of Fig. 19C positioned within a recess of the tibial bearing component of Fig. 19A.
  • the present disclosure provides a provisional tibial prosthesis system for a set of prosthetic knee joints for implantation in a natural knee, the provisional tibial prosthesis system including a bearing component and a bearing support, the spacing of the bearing component from the bearing support is adjustable to allow for representation of a variety of different sized final tibial prostheses.
  • the provisional tibial prosthesis system of the present disclosure may be used with a final tibial prosthesis in accordance with the tibial prosthesis described in U.S. Patent
  • Fig. 6 illustrates a natural knee comprising proximal tibial T and distal femur F.
  • Fig. 6 depicts a coordinate system of the natural knee including anterior/posterior axis AA- P ,
  • Anterior/posterior axis AA_ P corresponds to anterior/posterior direction 20
  • medial/lateral axis A M - L corresponds to medial/lateral direction 22
  • proximal/distal axis A P _ D corresponds to proximal/distal direction 24.
  • Anterior/posterior direction 20, medial/lateral direction 22, and proximal/distal direction 24 are each normal to one another.
  • proximal refers to a direction generally toward the heart of a patient
  • distal refers to the opposite direction of proximal, i.e., away from the heart of the patient.
  • anterior refers to a direction generally toward the front of a patient
  • posterior refers to the opposite direction of anterior, i.e., toward the back of a patient.
  • medial refers to a direction generally toward the middle of a patient
  • lateral refers to the opposite direction of medial, i.e., toward the side of a patient.
  • the disclosed embodiments of the present disclosure include a tibial bearing component and a base component.
  • provisional tibial prosthesis system 30A includes tibial bearing component 32A and base component 34A.
  • Reference numbers for the provisional tibial prosthesis system, the tibial bearing component, and the base component utilize the same numerical reference number combined with different letters to distinguish the exemplary embodiment (i.e., tibial bearing component 32A, 32B, 32C, etc. respectively correspond to the first, second, and third exemplary embodiments, etc.).
  • a reference numeral followed by A-K corresponds to a similar feature between the exemplary first through eleventh embodiments, respectively.
  • the first exemplary embodiment includes tibial bearing component 32A generally including tibial bearing component inferior surface 42A, opposing tibial bearing component superior
  • Tibial bearing component 32A includes bearing anterior side 48A, bearing posterior side 50A, bearing lateral side 52A, and bearing medial side 54A.
  • Superior surface 44A is adapted to articulate with condyles of a distal femur F (shown in Figs. 6-8), or condyles of a femoral component (not shown) secured to a distal end of a femur.
  • Superior surface 44A includes bearing lateral articular surface 56A in bearing lateral side 52A and bearing medial articular surface 58 A in bearing medial side 54A, with central tibial eminence 60A disposed between bearing articular surfaces 56A, 58A.
  • eminence 60A generally corresponds in shape and size with the natural tibial eminence of a proximal tibial T (shown in Figs. 6-8) prior to resection.
  • Tibial bearing component 32A further includes PCL cutout 62A disposed at posterior side 50A between lateral articular surface 56A and medial articular surface 58 A.
  • PCL cut-out 62 A is sized and positioned to correspond with a posterior cruciate retaining ligament of a knee joint.
  • tibial bearing component 32A is illustrated as a cruciate retaining bearing component though it is contemplated that other tibial bearing components may be utilized in accordance with the present disclosure such as bearing components which cooperate to form a posterior stabilized prosthesis or a knee prosthesis having an intermediate level of constraint between a posterior stabilized and cruciate retaining prosthesis.
  • Tibial bearing component 32A may also be made available in a variety of shapes and sizes to accommodate a variety of knee joints.
  • tibial bearing inferior surface 42A of tibial bearing component 32A includes slots 64A, alignment pins 68A, bearing cavity 70A, and bearing nub cavities 72A.
  • slots 64A are exposed at anterior side 48A and extend from anterior side 48A toward posterior side 50A within tibial bearing component 32A in a direction parallel to anterior/posterior axis AA- P .
  • slots 64A have tapering walls 66A.
  • alignment pins 68A are located between slots 64A at anterior side 48A.
  • Bearing cavity 70A extends from inferior surface 42A towards superior surface 44A and is sized to accept protrusion 96A (shown in Fig. 3 A) of base component 34A. Further, bearing cavity 70A includes bearing nub cavities 72 A which extend on opposing sides of bearing cavity 70 A and are each sized to receive a nub 104A (shown in Fig. 3 A) located on protrusion 96A of base component 34A.
  • the first exemplary embodiment also includes base component 34A generally including base component inferior surface 82 A, opposing base component superior surface 84A, and base component peripheral wall 86A extending from inferior surface 82A to superior surface 84A.
  • Base component 34A includes base anterior side 88 A, base posterior side 90 A, base lateral side 92 A, and base medial side 94 A.
  • Base component 34A includes protrusion 96A extending from superior surface 84A.
  • Protrusion 96A includes nubs 104A which extend on opposing sides of protrusion 96A.
  • protrusion bottom wall 100A spans the distance between protrusion 96A and superior surface 84A. Further, protrusion 96A and bottom wall 100A define bottom wall indentations 102A between protrusion 96A and superior surface 84A.
  • Base component 34 A also includes notch 106A at posterior side 90A having a generally W-shape, undercut portion 108 A, medial side groove 110A, and lateral side groove 112 A.
  • Fig. 5 illustrates tibial base plate 38A according to an exemplary embodiment of the present disclosure.
  • Tibial base plate 38A generally includes base plate superior surface 150A and opposing base plate bone contacting surface 152A.
  • Tibial base plate 38A closely corresponds in size and shape with the resected proximal tibia surface, and includes base plate peripheral wall 156A extending from bone contacting surface 152A to superior surface 150A.
  • Base plate peripheral wall 156A includes raised perimeter 158A and tibial base plate 38A includes base plate anterior side 166A, base plate posterior side 168 A, base plate medial side 170A, and base plate lateral side 172A.
  • Superior surface 150A includes medial condylar portion 160 A and lateral condylar portion 162 A.
  • Base plate 38A further includes PCL cut-out 164A disposed at posterior side 168 A between medial condylar portion 160A and lateral condylar portion 162A to allow a posterior cruciate retaining ligament of a knee joint to pass therethrough.
  • tibial base plate 38A includes boss 174 A having boss medial sides 176 A and boss lateral sides 178 A. Further, an interior recess is formed between inner medial side 176A and inner lateral side 178 A.
  • tibial base plate 38A is attached to a proximal tibia.
  • the proximal portion of a patient's tibia is resected to provide a substantially flat surface for receipt of bone contacting surface 152 A of tibial base plate 38 A.
  • tibial base plate 38A is implanted and secured to the resected proximal tibia using standard surgical techniques.
  • conventional features such as a stem and fins may be located on bone contacting surface 152A to affect securement of tibial base plate 38A to a proximal tibia.
  • tibial base plate 38A is part of the provisional prosthesis system disclosed herein, tibial base plate 38A may also be part of a final prosthesis system, i.e., tibial base plate 38A is the final base plate implanted to a resected proximal tibia. Tibial base plate 38A may also be part of any other tibia contacting implement utilized in knee arthroplasty.
  • tibial base plate 38A could be part of a tibial sizing plate system in accordance with the tibial sizing plate described in U.S. Patent No.
  • Tibial base plate 38A may also be part of a tibial sizing plate system in accordance with the tibial sizing plate described in two brochures published by Zimmer, Inc., namely the "Zimmer® Patient Specific Instruments, Surgical Techniques for NexGen® Complete Knee Solution” brochure, copyright 2010, and the "Zimmer® NexGen Trabecular Metal Tibial Tray, Surgical Technique” brochure,
  • base component 34A is secured to tibial base plate 38A by positioning base component inferior surface 82 A on base plate superior surface 150A.
  • Undercut portion 108A (shown in Figs. 3B and 3C) of base component 34A is positioned within raised perimeter 158 A (shown in Fig. 5) of base plate peripheral wall 156A.
  • Raised perimeter 158A acts as a physical barrier to prevent base component 34A from significant relative movement relative to tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20.
  • base component 34A is movable relative to tibial base plate 38A in proximal/distal direction 24.
  • base component 34A is sized to have clearance with tibial base plate 38 A, i.e., some movement between base component 34A and tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20 is allowable, but base component 34A and tibial base plate 38A are prohibited from disengagement in medial/lateral direction 22 and
  • anterior/posterior direction 20 anterior/posterior direction 20.
  • tibial bearing component 32A is positioned atop tibial base plate 38 A.
  • bearing inferior surface 42A (shown in Fig. 2C) of bearing component 32A is positioned within raised perimeter 158A of base plate peripheral wall 156A in a manner similar to the attachment between base component 34A and tibial base plate 38A discussed above.
  • Raised perimeter 158A again acts as a physical barrier to prevent bearing component 32A from significant relative movement relative to tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20.
  • bearing component 32A is movable relative to tibial base plate 38A in proximal/distal direction 24.
  • bearing component 32A is sized to have clearance with tibial base plate 38 A, i.e., some movement between bearing component 32A and tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20 is allowable, but bearing component 32A and tibial base plate 38A are prohibited from disengagement in medial/lateral direction 22 and anterior/posterior direction 20.
  • any of the disclosed exemplary first through eleventh embodiments are attachable to a tibial base plate such as tibial base plates 38 A, 38B respectively shown in Figs. 5 and 9. It is also contemplated that other tibial base plates having a variety of different sizes and shapes can be used in accordance with the provisional tibial prosthesis systems of the present disclosure.
  • Tibial bearing component 32A is positioned atop base component 34A by positioning protrusion 96A of base component 34A within bearing cavity 70A of tibial bearing component 32A and positioning nubs 104 A of protrusion 96A respectively within bearing nub cavities 72A.
  • base component 34A is locked to tibial bearing component 32A in medial/lateral direction 22 when protrusion 96A is received within bearing cavity 70A and base component 34A is locked to tibial bearing component 32A in anterior/posterior direction 20 when nubs 104A are respectively received within nub cavities 72 A.
  • the walls of bearing cavity 70 A provide a physical barrier to prevent significant relative movement between base component 34A and tibial bearing component 32A in medial/lateral direction 22 and the walls of nub cavities 72A provide a physical barrier to prevent significant relative movement between base component 34A and tibial bearing component 32A in anterior/posterior direction 20.
  • tibial bearing component 32A When tibial bearing component 32A is positioned atop base component 34A, tibial bearing component 32A is movable relative to base component 34A in proximal/distal direction 24.
  • base component 34A is secured to tibial base plate 38A and base component 34A is located between tibial bearing component 32A and tibial base plate 38 A.
  • tibial bearing component 32A can be positioned directly atop tibial base plate 38 A.
  • Figs. 4A-4C illustrate shim 36A according to an exemplary embodiment of the present disclosure.
  • Shim 36A generally includes shim inferior surface 122A, opposing shim superior surface 124 A, and shim peripheral wall 126 A extending from inferior surface 122 A to superior surface 124A.
  • Shim peripheral wall 126A defines a shim exterior profile. In one embodiment, the shim exterior profile substantially matches the tibial base plate exterior profile.
  • Shim 36A also includes shim anterior side 128A, shim posterior side 130A, shim lateral side 132A, and shim medial side 134A.
  • shim superior surface 124A includes rails 136A and handle alignment rails 142A. As illustrated in Figs. 4A and 4B, rails 136A extend from anterior side 128A toward posterior side 130A parallel to
  • rails 136A have lead-in edges 140 A and tapered walls 138A.
  • Handle alignment rails 142 A are located between rails 136A at anterior side 128A.
  • shim ramp 148A is located between handle alignment rails 142A between handle alignment rails 142A.
  • Shim 36A also includes shim notch 144A and lead-in walls 146A, i.e., tapering posterior walls, at posterior side 130A for aligning shim 36A and guiding insertion of shim 36A in anterior/posterior direction 20, as will be further described below.
  • a set of a plurality of shims 36A can be provided to allow for varying levels of adjustment of provisional tibial prosthesis system 30A, i.e., increasing the distance between tibial bearing component 32A and base component 34A by the shim height of a particular shim 36A inserted therebetween.
  • the height of the shims could be 1 mm, 2 mm, 3 mm, and 4 mm.
  • a set of shims could include a plurality of shims having equal sizes for stacking shims.
  • the stacking shims embodiment can also include a plurality of shims having varying heights. It is envisioned that the set of a plurality of different sized shims 36A could include any desired number of different sized shims having any number of shim heights.
  • lead-in walls 146A of shim 36A are placed between bearing component 32A and base component 34A and are used to affect separation of bearing component 32A from base component 34A by a distance along proximal/distal axis A P _ D equal to a height of shim 36 A.
  • lead-in walls 146 A act as a ramp to separate bearing component 32A from base component 34A.
  • the provisional tibial prosthesis system of the present disclosure can be adjusted in a manner requiring the knee joint to only be distracted by a distance equal to the height of shim 36A.
  • bearing component inferior surface 42A (shown in Fig. 2C) at bearing anterior side 48A (shown in Figs. 2A-2C) can include a beveled edge corresponding to lead-in walls 146A of shim 36 A.
  • shim 36A is slidably receivable between tibial bearing component 32A and base component 34A in anterior/posterior direction 20.
  • the insertion of shim 36A between tibial bearing component 32A and base component 34A in anterior/posterior direction 20 allows tibial bearing component 32A to only be separated from base component 34A by a distance along proximal/distal axis A P _ D equal to the height of shim 36A.
  • tibial bearing component 32A and base component 34A of provisional tibial prosthesis system 30A do not have to be removed from the knee joint to insert and remove shims 36 A.
  • base component 34A is not utilized and shim 36A is positioned between bearing component 32A and base plate 38A.
  • tibial bearing component 32A is positioned atop tibial base plate 38A such that bearing inferior surface 42A (shown in Fig. 2C) of bearing component 32A is positioned within raised perimeter 158A of base plate peripheral wall 156A. Referring to Fig.
  • the anterior rail of base plate 38A will be missing to allow shim 36A to be slidably receivable between tibial bearing component 32A and tibial base plate 38A in anterior/posterior direction 20 using lead-in walls 146A of shim 36A to separate tibial bearing component 32A from tibial base plate 38A by a distance along proximal/distal axis A P _ D equal to a height of shim 36 A.
  • shim 36A will have a perimeter configured to allow shim 36A to be positioned to the securement features of base plate 38 A.
  • shim 36A will have a perimeter similar to the perimeter of base component 34A (shown in Fig. 3 A).
  • tibial bearing component 32A when tibial bearing component 32A is positioned atop base component 34A, tibial bearing component 32A is movable relative to base component 34A in proximal/distal direction 24.
  • shim 36A takes away this last degree of freedom between tibial bearing component 32A and base component 34A, i.e., when shim 36A is received between base component 34A and tibial bearing component 32A, shim 36A locks tibial bearing component 32A to base component 34A in proximal/distal direction 24, i.e., significant relative movement between tibial bearing component 32A and base component 34A in proximal/distal direction 24 is prevented.
  • shim 36A locks tibial bearing component 32A to base component 34A in proximal/distal direction 24.
  • shim 36A is inserted between tibial bearing component 32A and base component 34A in anterior/posterior direction 20.
  • shim rails 136A are aligned with respective tibial bearing component slots 64A.
  • rails 136A each include lead-in edge 140 A to guide insertion of rails 136A in slots 64 A.
  • the rail/slot connection between shim 36A and tibial bearing component 32A is important because it prevents lift-off of tibial bearing component 32A from shim 36A, i.e., prevents significant relative movement between tibial bearing component 32A and shim 36A in proximal/distal direction 24.
  • slots 64A of tibial bearing component 32A and rails 136A of shim 36A each have a dovetail cross-sectional shape.
  • slots 64A including tapering walls 66A of bearing component 32A cooperate with rails 136A having tapering walls 138A of shim 36A to act as a physical barrier to prevent lift-off of the tibial bearing component 32A from shim 36A.
  • slots 64A of tibial bearing component 32A and rails 136A of shim 36A can each have a T-shaped cross-sectional shape or other various shapes that would provide a physical barrier that would prevent lift-off, i.e., prevent significant relative movement between tibial bearing component 32A and base component 34A in proximal/distal direction 24, or any movement of tibial bearing
  • shim 36A As shim 36A is inserted in anterior/posterior direction 20 between tibial bearing component 32A and base component 34A using lead-in walls 146A as discussed above, shim 36A also locks to base component 34A by shim notch 144A formed in shim posterior side 130A attaching to base component 34A by sliding notch 144A in
  • Tibial bearing component 32L and shim 36L respectively include similar components to tibial bearing component 32A illustrated in
  • tibial bearing component 32L includes recess 78L extending from bearing component inferior surface 42L towards bearing component superior surface 44L. Recess 78L is sized to receive shim 36L (shown in Figs. 19C and 19D).
  • Fig. 19E illustrates shim 36L received in recess 78L of tibial bearing component 32L. Referring to Figs.
  • shim rails 136L are aligned with respective tibial component slots 64L.
  • Rails 136L of shim 36L each include lead-in edge 140L to guide insertion of rails 136L in slots 64L of tibial bearing component 32L.
  • Shim 36L is inserted in recess 78L of tibial bearing component 32L in anterior/posterior direction 20 (shown in Fig. 6).
  • the height of shim 36L is equal to the height of recess 78L of tibial bearing component 32L. In other embodiments, the height of shim 36L could be less than the height of recess 78L.
  • shim 36L locks tibial bearing component 32L to shim 36L in proximal/distal direction 24 (shown in Fig. 6) without spacing tibial bearing component 32L from a base component, i.e., either base component 34A (shown in Figs. 3A-3C), tibial base plate 38A (shown in Fig. 5), or other tibia contacting implement utilized in knee arthroplasty.
  • a base component i.e., either base component 34A (shown in Figs. 3A-3C), tibial base plate 38A (shown in Fig. 5), or other tibia contacting implement utilized in knee arthroplasty.
  • tibial bearing component 32L Before shim 36L is inserted between tibial bearing component 32L and base component 34A (shown in Figs. 3A-3C), tibial bearing component 32L is positioned on base component 34A. With tibial bearing component 32L positioned on base component 34A, recess 78L spaces tibial bearing component 32L from base component 34A a distance along
  • tibial bearing component 32L can be positioned on base component 34A by positioning protrusion 96A of base component 34A within bearing cavity 70L of tibial bearing component 32L and positioning nubs 104A of protrusion 96A respectively within bearing nub cavities 72L. Subsequently, shim 36L can be inserted between tibial bearing component 32L and base component 34A in anterior/posterior direction 20 (shown in Fig. 6).
  • shim 36L With shim 36L inserted within recess 78L of tibial bearing component 32L, shim 36L prevents significant relative movement between tibial bearing component 32L and base component 34A in proximal/distal direction 24 (shown in Fig. 6) without spacing tibial bearing component 32L from base component 34A.
  • the height of shim 36L cooperates with the height of tibial bearing component 32L to represent a first final tibial prosthesis without shim 36L adding to the height of tibial bearing component 32L.
  • a surgeon selects a provisional tibial prosthesis system, such as provisional tibial prosthesis system 3 OA, having tibial base plate 38A (shown in Fig.
  • tibial bearing component 32A having a tibial bearing component height
  • tibial bearing component 32A attachable to tibial base plate 38A
  • shim 36A having a shim height
  • shim 36A slidably receivable between tibial base plate 38A and tibial bearing component 32A in anterior/posterior direction 20 when tibial base plate 38A and tibial bearing component 32A are separated by a distance along proximal/distal axis A P _ D equal to the shim height.
  • proximal portion of a patient's tibia is resected using standard surgical techniques to provide a substantially flat surface for receipt of bone contacting surface 152A of tibial base plate 38 A.
  • tibial base plate 38A is implanted and secured to the resected proximal tibia. Subsequently, tibial bearing component 32A
  • tibial base plate 38A corresponding to the constraint level chosen by the surgeon is positioned atop tibial base plate 38A such that bearing inferior surface 42A (shown in Fig. 2C) of bearing component 32A is positioned within raised perimeter 158A (shown in Fig. 5) of base plate peripheral wall 156A. If base component 34A is utilized, base component 34A is positioned atop tibial base plate 38A between bearing component 32A and base plate 38 A.
  • the surgeon can then perform range of motion testing of the knee joint to verify proper sizing of the provisional tibial prosthesis system. If a surgeon determines that a provisional tibial prosthesis system is properly sized with tibial bearing component 32A positioned atop tibial base plate 38 A, a first final tibial prosthesis can be selected which corresponds to the height of tibial bearing component 32A.
  • tibial bearing component 32A can be spaced from tibial base plate 38A by sliding shim 36A having a first shim height, e.g., 1 mm, between tibial base plate 38A and tibial bearing component 32A in anterior/posterior direction 20.
  • the surgeon can then perform range of motion testing of the knee joint to verify proper sizing of the provisional tibial prosthesis system with shim 36A having a first shim height inserted between tibial bearing component 32A and tibial base plate 38 A.
  • the surgeon can select a second final tibial prosthesis represented by the first shim height and the tibial bearing component height.
  • the provisional tibial prosthesis system is not properly sized after insertion of shim 36A having the first shim height, e.g., 1 mm, the 1 mm shim 36A can be removed in anterior/posterior direction 20, another shim 36A may be selected having a second height, e.g., 2 mm, and tibial bearing component 32A can then be spaced from tibial base plate 38A by sliding shim 36A having the second shim height between tibial base plate 38A and tibial bearing component 32A in anterior/posterior direction 20.
  • the surgeon can select a third final tibial prosthesis represented by the second shim height and the tibial bearing component height.
  • shim 36A having a first shim height e.g. 1 mm
  • a surgeon determines that the provisional tibial prosthesis system with shim 36A having the first shim height is not properly sized
  • shim 36A having a height of 1 mm can be left between tibial base plate 38A and tibial bearing component 32A
  • a second shim 36A having a second shim height e.g., 1 mm
  • shim 36A may not include either the securement features discussed above that lock shim 36A to tibial bearing component 32A or the securement features discussed above that lock shim 36A to base component 34A.
  • shim 36A may not include rails 136A so that tibial bearing component 32A can move relative to shim 36A in proximal/distal direction 24 (shown in Fig. 6) when shim 36A is inserted between base plate 38A and bearing component 32A.
  • a second shim can be inserted in anterior/posterior direction 20 between base plate 38A and bearing component 32A with a first shim already positioned between base plate 38 A and bearing component 32A.
  • the surgeon can select a third final tibial prosthesis represented by the first shim height, the second shim height, and the tibial bearing component height.
  • This stacking of the shims can be repeated using a variety of different sized shims and a variety of different numbered shims for a surgeon to determine the proper thickness of a provisional tibial prosthesis system.
  • several shims all having the same height can be used in series to adjust the spacing of bearing component 32A from base plate 38 A.
  • Surgical instrument 180 generally includes handle body 182, handle end 184, opposing attachment end 186, alignment pins 188, tooth 190, button 192, and handle pegs 194.
  • Surgical instrument 180 has one alignment pin 188 on each side of tooth 190. Alignment pins 188 fit in respective exterior circular recesses in rails 142A (shown in Fig. 4B) of shim 36A to properly align surgical instrument 180 to shim 36A.
  • tooth 190 of surgical instrument 180 slides along shim ramp 148A (shown in Figs. 4A and 4B) and, when tooth 190 slides past shim ramp 148 A, a biasing force on tooth 190 causes tooth 190 to travel downward and engage the backside of shim ramp 148A to lock surgical instrument 180 to shim 36A.
  • a biasing force is exerted on tooth 190 by a tension spring.
  • a surgeon holding handle end 184 of surgical instrument 180 can insert shim 36A in anterior/posterior direction 20 between tibial bearing component 32A and tibial base plate 38A to space tibial bearing component 32A from tibial base plate 38A along proximal/distal axis A P _ D a distance equal to the shim height.
  • release button 192 of surgical instrument 180 can be depressed to overcome the biasing force of the spring to release and disengage tooth 190 from the backside of shim ramp 148 A. Thereafter, surgical instrument 180 can be removed.
  • surgical instrument 180 can be used in the manner described above to insert shim 36A in anterior/posterior direction 20 between tibial bearing component 32A and base component 34A. Also, surgical instrument 180 may be used to remove shim 36A from between tibial bearing component 32A and base component 34A. [0088] Once the proximal portion of a patient's tibia is resected and the tibial prosthesis components of the present disclosure are secured to the resected proximal tibia, soft tissue balancing of the knee can be performed. Subsequently, a sizing guide can be attached to the tibial prosthesis components.
  • the sizing guide can include alignment pins that fit in respective exterior circular recesses in rails 142A (shown in Fig. 4B) of shim 36A to properly align the sizing guide to shim 36A.
  • a locking component of the sizing guide can slide along shim ramp 148 A (shown in Figs. 4A and 4B) and, when the locking component slides past shim ramp 148 A, a biasing force on the locking component can cause the locking component to travel downward and engage the backside of shim ramp 148A to lock the sizing guide to shim 36A.
  • a cut guide such as a femoral finishing cut guide can be attached to shim 36 A.
  • Fig. 9 illustrates an exemplary second embodiment.
  • the several embodiments of the present disclosure include similar components to the embodiment illustrated in Figs. 1-8. For the sake of brevity, these similar components will not all be discussed in conjunction with the various alternative embodiments disclosed herein.
  • Exemplary second embodiment provisional tibial prosthesis system 30B includes tibial bearing component 32B, base component 34B, shim component 36B, and tibial base plate 38B.
  • tibial bearing component 32B is positioned atop base component 34B in a manner similar to the arrangement of tibial bearing component 32A to base component 34A discussed above.
  • protrusion 96B is similar to protrusion 96A (shown in Figs.
  • bearing cavity 70A (shown in Figs. 2C and 2D) is similar to a cavity (not shown) in bearing component inferior surface 42B.
  • bearing component 32B is positioned atop base component 34B by positioning protrusion 96B of base component 34B within a bearing cavity in inferior surface 42B of bearing component 32B to lock bearing component 32B to base component 34B in medial/lateral direction 22 and anterior/posterior direction 20.
  • shim 36B is slidably receivable between tibial bearing component 32B and base component 34B in anterior/posterior direction 20.
  • a set of different sized shims 36B can be provided to allow for varying levels of adjustment of provisional tibial prosthesis system 30B, i.e., increasing the distance between tibial bearing component 32B and base component 34B by the shim height of a particular shim 36B inserted therebetween.
  • shim superior surface 124B includes lateral alignment bump 139B and medial alignment bump 14 IB which respectively cooperate with lateral alignment bump 116B and medial alignment bump 114B of base component 34B to align shim 36B and guide insertion of shim 36B in anterior/posterior direction 20.
  • alignment bumps 139B, 141B are placed between bearing component 32B and respective alignment bumps 114B, 116B of base component 34B and are used to affect separation of bearing component 32B from base component 34B by a distance along proximal/distal axis A P _ D equal to a height of shim 36B.
  • Alignment bumps 139B, 141B of shim 36B and alignment bumps 1 14B, 116B of base component 34B each include a protrusion portion on a proximal side and a recessed portion on a distal side.
  • the insertion end of shim 36B could include lead-in walls similar to lead-in walls 146 A (shown in Figs. 4 A and 4C) to act as a ramp to separate bearing component 32B from base component 34B.
  • every embodiment of the present disclosure including a shim component slidably insertable between a bearing component and a bearing support could include an insertion end having a lead-in wall to act as a ramp to separate the bearing component from the bearing support.
  • shim 36B includes locking tabs 137B located at shim anterior side 128B.
  • shim 36B Upon insertion of shim 36B between tibial bearing component 32B and base component 34B, shim 36B respectively locks shim 36B to tibial bearing component 32B by a first tab 137B engaging in notch 74B of tibial bearing component 32B and locks shim 36B to base component 34B by a second tab 137B engaging base component 34B at anterior side 88B.
  • shim 36B takes away the last degree of freedom between tibial bearing component 32B and base component 34B, i.e., when shim 36B is received between base component 34B and tibial bearing component 32B, shim 36B limits movement between tibial bearing component 32B and base component 34B in proximal/distal direction 24.
  • a surgeon can grasp tabs 137B to insert or remove shim 36B from bearing component 32B and base component 34B.
  • a surgeon can use a standard surgical instrument for insertion or removal of shim 36B.
  • base component 34B is not utilized and shim 36B is positioned between bearing component 32B and base plate 38B.
  • the anterior rail of base plate 38B will be missing to allow shim 36B to be slidably receivable between tibial base plate 38B and tibial bearing component 32B in anterior/posterior direction 20.
  • shim 36B having a first shim height e.g. 1 mm
  • a surgeon determines that the provisional tibial prosthesis system with shim 36B having the first shim height is not properly sized shim 36B having a height of 1 mm can be left between base plate 38B and tibial bearing component 32B, and a second shim having a second shim height, e.g., 1 mm, can be inserted between base plate 38B and bearing component 32B to separate bearing component 32B from base plate 38B by a distance along proximal/distal axis Ap_ D equal to the first shim height and the second shim height.
  • shim 36B will not include tabs 137B so that bearing component 32B can move relative to shim 36B in proximal/distal direction 24 (shown in Fig. 6) when shim 36B is inserted between base plate 38B and bearing component 32B.
  • a second shim can be inserted in anterior/posterior direction 20 between base plate 38B and bearing component 32B with a first shim already positioned between base plate 38B and bearing component 32B.
  • a standard surgical instrument such as forceps can be used for insertion or removal of shim 36B from bearing component 32B and base component 34B.
  • base component 34B includes apertures 118B. As illustrated in Fig. 9, two apertures 118B are located near lateral portion 92B and two apertures 118B are located near medial portion 94B. Apertures 118B could receive pegs (not shown) extending from base plate superior surface 150B to allow base plate 38B to snap fit together with base component 34B.
  • Base plate 38B includes boss 174B having boss anterior side 175B, boss medial side 176B, boss posterior side 177B, boss lateral side 178B, and boss winged
  • Figs. 1 OA- IOC illustrate an exemplary third embodiment.
  • Exemplary third embodiment provisional tibial prosthesis system 30C includes tibial bearing component 32C, base component 34C, and pin shim component 36C having lateral pin 121C, medial pin 123C, and handle 125C.
  • Tibial bearing component inferior surface 42C includes eight posts 73 C extending in a distal direction therefrom. For example, four posts 73 C are located beneath medial articular surface 58C and four posts 73C extend beneath lateral articular surface 56C.
  • base component 34C includes eight apertures 113C extending through base component 34C from inferior surface 82C to superior surface 84C.
  • apertures 113C are located in medial portion 94C and four apertures 113C are located in lateral portion 92C.
  • Each aperture 113C receives a single post 73C of tibial bearing component 32C therein to secure tibial bearing component 32C to base component 34C.
  • corresponding posts 73C and apertures 113C lock tibial bearing component 32C to base component 34C in medial/lateral direction 22 and anterior/posterior direction 20.
  • tibial bearing component 32C is moveable relative to base component 34C in proximal/distal direction 24.
  • provisional tibial prosthesis system 30C is positioned in a knee joint, the knee joint will exert forces in proximal/distal direction 24 to keep tibial bearing component 32C from pulling off base component 34C.
  • tibial bearing component inferior surface 42C includes curved lateral groove 75 C and curved medial groove 77C therein, and base component superior surface 84C includes curved lateral groove 115C and curved medial groove 117C therein.
  • Lateral groove 75 C and lateral groove 115C correspond to form first mating hole portion 200C and medial groove 77C and medial groove 117C correspond to form second mating hole portion 202C.
  • mating hole portion 200C receives pin 121C therein and mating hole portion 202C receives pin 123C therein.
  • pin shim 36C to change the thickness of provisional tibial prosthesis system 30C, i.e., the distance between tibial bearing component 32C and base component 34C, will now be described.
  • pins 121C, 123C are slidably received between base component 34C and tibial bearing component 32C, within respective mating hole portions 200C, 202C, in anterior/posterior direction 20.
  • mating hole portions 200C, 202C each have a variable mating hole diameter dhi, dh 2 .
  • dhi variable mating hole diameter
  • the diameters of mating hole portions 200C, 202C decrease from anterior side 48C to posterior side 50C.
  • mating hole diameter dh 2 is greater than mating hole diameter dhi.
  • the diameter of pins 121C, 123C are equal, i.e., pin diameter dpi is equal to pin diameter dp 2 . Accordingly, because mating hole diameters dhi, dh 2 decrease towards posterior side 50C, the further pin shim 36C is slid within mating hole portions 200C, 202C, the distance between tibial bearing component 32C and base component 34C is increased. [0099] In another exemplary embodiment, referring to Fig.
  • the diameter of pins 121C, 123C vary and mating hole diameters dhi, dh 2 of mating hole portions 200C, 202C remain the same.
  • pin diameter dp 2 is greater than pin diameter dpi for both pins 121C and 123C.
  • mating hole diameter dhi and dh 2 are equal throughout mating hole portions 200C, 202C.
  • the pin diameters of pins 121C, 123C increase in a direction towards handle 125C, the further pin shim 36C is slid within mating hole portions 200C, 202C, the distance between tibial bearing component 32C and base component 34C is increased.
  • both pin diameters dpi, dp 2 of pins 121C, 123C and mating hole diameters dhi, dh 2 of mating hole portions 200C, 202C vary.
  • pin diameter dp 2 is greater than pin diameter dpi for both pins 121C and 123C and mating hole diameter dh 2 is greater than mating hole diameter dhi for both mating hole portions 200C, 202C.
  • Such an embodiment allows for the greatest thickness adjustment because not only does the mating hole diameters decrease towards posterior side 50C, the pin diameters increase towards handle 125C.
  • the further pin shim 36C is slid within mating hole portions 200C, 202C, the distance between tibial bearing component 32C and base component 34C is increased.
  • a set of different sized pin shims 36C can be provided to allow for varying levels of adjustment of provisional tibial prosthesis system 30C, i.e., increasing the distance between tibial bearing component 32C and base component 34C by the diameters of pins 121C, 123C. It is envisioned that the set of different sized pin shims 36C could include any desired number of different sized pin shims 36C having any number of different pin diameters.
  • Figs. 11 A and 1 IB illustrate an exemplary fourth embodiment.
  • Exemplary fourth embodiment provisional tibial prosthesis system 30D includes tibial bearing component 32D, base component 34D, and sliding wedge 36D.
  • Base component superior surface 84D includes base component medial alignment bump 114D and base component lateral alignment bump 116D.
  • Tibial bearing component 32D is positioned on base component 34D such that bearing inferior surface 42D is adjacent to base component superior surface 84D as illustrated in Fig. 11B.
  • Sliding wedge 36D is generally U-shaped and includes tab 137D, lateral alignment bump 139D, medial alignment bump 141D, lateral wing 143D, anterior wedge portion 144D, and medial wing 145D.
  • lateral wing 143D and medial wing 145D each include lead-in edge 140D, which function similarly to lead-in walls 146A as discussed above.
  • Anterior wedge portion 144D includes lateral wing 143D and medial wing 145D extending at opposing sides of anterior wedge portion 144D.
  • tab 137D extends from anterior wedge portion 144D.
  • indicia of a particular sized thickness of sliding wedge 36D can be included on tab 137D.
  • Sliding wedge 36D can be provided in a variety of different thicknesses to provide for varying levels of adjustment of provisional tibial prosthesis system 30D, i.e., increasing the distance between tibial bearing component 32D and base component 34D. For example, if four different sizes were to be used in the set of sliding wedges 36D, the height of sliding
  • wedges 36D could be 1 mm, 2 mm, 3 mm, and 4 mm. It is envisioned that the set of different sized sliding wedges 36D could include any desired number of different sized wedges 36D having any number of different wedge heights.
  • sliding wedge lateral alignment bump 139D and sliding wedge medial alignment bump 14 ID are respectively aligned with base component lateral alignment bump 116D and base component medial alignment bump 114D to properly orientate sliding wedge 36D between tibial bearing component 32D and base component 34D.
  • lead-in edges 140D of sliding wedge 36D are placed between tibial bearing component 32D and base component 34D to effect separation of bearing component 32D from base component 34D and wedge 36D is slidably inserted between base component 34D and tibial bearing component 32D in anterior/posterior direction 20.
  • Alignment bumps 139B, 141D of sliding wedge 36D include a protrusion portion on a proximal side and a recessed portion on a distal side.
  • the shims of the present disclosure can be made of a surgical grade material such as stainless steel, various alloys such as a cobalt-chromium alloy, and various ceramics such as silicon nitride.
  • the shims can also be made of various plastics including polyethylene and polyphenylsulfone. In certain embodiments, the shims of the present disclosure will be disposable after a single use.
  • Figs. 12A-12C illustrate an exemplary fifth embodiment.
  • provisional tibial prosthesis system 30E includes tibial bearing component 32E, upper base component 220E, lower base component 250E, and tapered screws 280E.
  • Upper base component 220E generally includes upper base component inferior surface 222E, opposing upper base component superior surface 224E, upper base component peripheral wall 226E extending from inferior surface 222E to superior surface 224E, anterior side 228E, posterior side 230E, lateral side 232E, and medial side 234E.
  • Tibial bearing component inferior surface 42E includes central notch 6 IE extending from anterior side 48E towards posterior side 50E and having rail 63E extending distally from inferior surface 42E.
  • two protuberances 65E extend from side wall 67E into central notch 6 IE at a posterior end of central notch 6 IE.
  • Upper base component 220E further includes protruding member 236E extending proximally from superior surface 224E.
  • Protruding member 236E including slot 238E spanning a proximal most portion of protruding member 236E from anterior side 228E to posterior side 230E.
  • protruding member 236E includes side grooves 240E.
  • Tibial bearing component 32E is positionable on upper base component 220E by positioning rail 63E of tibial bearing component 32E within slot 238E of upper base component 220E. This arrangement will also cause protuberances 65E to lock into respective side grooves 240E.
  • tibial bearing component 32E when tibial bearing component 32E is positioned atop upper base component 220E, tibial bearing component 32E is locked to upper base component 220E in medial/lateral direction 22 and proximal/distal direction 24.
  • Upper base component 220E includes posts 242E extending distally from inferior surface 222E.
  • lower base component 250E generally includes lower base component inferior surface 252E, opposing lower base component superior surface 254E, lower base component peripheral wall 256E extending from inferior surface 252E to superior surface 254E, anterior side 258E, posterior side 260E, lateral side 262E, and medial side 264E.
  • Lower base component 250E includes eight apertures 266E spanning from superior surface 254E to inferior surface 252E.
  • upper base component 220E and lower base component 25 OE are positioned together by inserting posts 242E of upper base component 220E in respective apertures 266E of lower base component 250E.
  • Inferior surface 222E of upper base component 220E also includes curved lateral groove 244E and curved medial groove 246E, both grooves 244E and 246E being threaded.
  • superior surface 254E of lower base component 250E includes curved lateral groove 268E and curved medial groove 270E, both grooves 268E and 270E being threaded.
  • tapered screws 280E generally include external threaded portions 282E and internal female hexagon socket 284E. Tapered screws 280E are threadably inserted into respective tapered holes 290E at anterior side 48E. Tapered screw 280E includes tapered screw diameter dtsi at posterior end 286E and tapered screw diameter dts 2 at anterior end 288E, tapered screw diameter dts 2 being greater than tapered screw diameter dtsi. Further, referring to Fig. 12C, each tapered hole 290E has tapered hole
  • tapered hole diameter dthi at posterior side 50E and tapered hole diameter dth 2 at anterior side 48E tapered hole diameter dth 2 being greater than tapered hole diameter dthi. Accordingly, as tapered screws 280E are screwed in an anterior to posterior direction, the distance between upper base component 220E and lower base component 250E is increased.
  • Figs. 13A and 13B illustrate an exemplary sixth embodiment.
  • Exemplary sixth embodiment provisional tibial prosthesis system 30F includes tibial bearing component 32F, base component 34F, wedge 36F, moving medial member 300F, moving lateral member 302F, medial base rail 308F, and lateral base rail 31 OF.
  • Base component superior surface 84F includes medial base rail 308F and lateral base rail 310F.
  • Medial member 300F includes medial member bottom slot 304F and lateral member 302F includes lateral member bottom slot 306F which respectively correspond to medial base rail 308F and lateral base rail 310F.
  • Slots 304F, 306F are respectively positioned atop rails 308F, 31 OF to secure medial member 300F and lateral member 302F to base component 34F.
  • slots 304F, 306F and rails 308F, 310F each have a corresponding dovetail shape and cooperate together to act as a physical barrier to prevent lift-off of medial member 300F and lateral member 302F from base component 34F while allowing medial member 300F and lateral member 302F to move in medial/lateral direction 22 over rails 308F, 310F.
  • Wedge component 36F generally includes wedge head portion 37F, wedge handle 39F, wedge medial slot 41F, and wedge lateral slot 43F.
  • Wedge component 36F is attachable to medial member 3 OOF and lateral member 302F by aligning wedge medial slot 4 IF and wedge lateral slot 43F respectively over medial member rail 312F and lateral member rail 314F which allows wedge component 36F to slide in an anterior/posterior direction relative to moving members 300F, 302F.
  • wedge head portion 37F pushes medial member 3 OOF and lateral member 302F outward in medial/lateral direction 22 over rails 308F, 310F.
  • the inclined surfaces (shown in Fig. 13B) of moving medial member 300F and moving lateral member 302F interface with inferior surface 42F of tibial bearing component 32F causing tibial bearing component 32F to move in a proximal direction away from base component 34F.
  • Fig. 14 illustrates an exemplary seventh embodiment.
  • Exemplary seventh embodiment provisional tibial prosthesis system 30G includes tibial bearing component 32G, base component 34G, and gear system 36G.
  • Base component superior surface 84G includes anterior post 95 G, lateral posterior post 97G, and medial posterior post 99G, posts 95 G, 97G, 99G each extending proximally from superior surface 84G.
  • Gear system 36G generally includes anterior gear 121G, lateral posterior gear 123G, and medial posterior gear 124G.
  • Posterior gears 123G, 124G include annular incline surfaces 125G located on top of gears 123G, 124G.
  • front anterior gear 121G includes front anterior gear teeth 127G
  • posterior gears 123G, 124G each include posterior gear teeth 129G.
  • front anterior gear 121G is attached to base component 34G by sliding aperture 131G of front anterior gear 121G over anterior post 95 G of base
  • lateral posterior gear 123G is attached to base component 34G by sliding aperture 131G of lateral posterior gear 123G over lateral post 97G of base
  • medial posterior gear 124G is attached to base component 34G by sliding aperture 131G of medial posterior gear 124G over medial posterior post 99G of base component 34G.
  • FIG. 14 the use of gear system 36G to adjust the distance of tibial bearing component 32G from base component 34G will now be described.
  • the portion of front anterior gear 121G exposed from tibial bearing component 32G and base component 34G at anterior side 88G can be turned by a surgeon's finger or a surgical instrument to turn front anterior gear 121G which causes posterior gears 123G, 124G to rotate.
  • Front anterior gear 121G is mechanically connected to posterior gears 123G, 124G by engagement of front anterior gear teeth 127G with rear posterior gear teeth 129G of lateral posterior gear 123G and medial posterior gear 124G. Rotation of posterior gears 123G, 124G causes annular incline
  • FIG. 15 illustrates an exemplary eighth embodiment.
  • provisional tibial prosthesis system 30H includes tibial bearing component 32H, base component 34H, pry bar 36H, lateral wing 45H, and medial wing 47H.
  • Base component superior surface 84H includes a plurality of steps 85H that are respectively located a distance closer to an inferior surface of tibial bearing component 32H as steps 85H extend inwardly from medial side 54H and lateral side 52H.
  • pry bar 36H is movably connected to tibial bearing component 32H and base component 34H via support members 41H and pins 43H.
  • exerting a force on tab 37H of pry bar 36H pushes up lifting member 39H of pry bar 36H to move tibial bearing component 32H away from base component 34H.
  • lateral wing 45H and medial wing 47H again maintain the distance between tibial bearing component 32H and base component 34H created by pry bar 36H.
  • lateral exposed end 49H of lateral wing 45H and medial exposed end 51H of medial wing 47H can be pushed in an outward direction away from pry bar 36H to push lateral wing 45H and medial wing 47H back to the initial position causing tibial bearing component 32H to collapse back to an initial position relative to base component 34H.
  • Figs. 16A-16C illustrate an exemplary ninth embodiment.
  • Exemplary ninth embodiment provisional tibial prosthesis system 301 includes tibial bearing component 321, base component 341, threaded cylinder 361, and locking cylinders 371.
  • Threaded cylinder 361 is positioned between tibial bearing component 321 and base component 341 by threadably attaching threaded cylinder 361 to threaded anterior post 851 extending from base component superior surface 841.
  • Threaded cylinder 361 is attached to tibial bearing component 321 via locking cylinders 371. Referring to Fig.
  • locking cylinders 371 are securely positioned within threaded cylinder annular groove 391 to threaded cylinder 361, and are also securely positioned within tibial bearing component receiving apertures 631 to tibial bearing component 321. Locking cylinders 371 prohibit relative axial movement between cylinder 361 and bearing component 321 while allowing relative rotational movement between cylinder 361 and bearing component 321. Posts 871, 891 prevent bearing component 321 from rotating relative to base component 341.
  • a tool having a hexagonal cross-section can be inserted in internal female hexagon socket 411 of threaded cylinder 361 to rotate threaded cylinder 361 on threaded anterior post 851 of base component 341.
  • tibial bearing component 321 which is connected to threaded cylinder 361 via locking cylinders 371 travels with threaded cylinder 361 in a proximal direction away from base component 341.
  • Figs. 17A-17C illustrate an exemplary tenth embodiment.
  • Exemplary tenth embodiment provisional tibial prosthesis system 30J includes tibial bearing component 32J, base component 34J, and component wedge assembly 36J.
  • Component wedge assembly 36J includes wedge head portion 37J having tab 39J exposed from tibial bearing component 32J, lateral wedge 41J, and medial wedge 43J.
  • Wedge head portion 37J, lateral wedge 41J, and medial wedge 43 J form an integral wedge piece that can move in anterior/posterior direction 20 relative to tibial bearing component 32J and base component 34J within tibial bearing component cavity 65 J.
  • Figs. 18 A- 18B illustrate an exemplary eleventh embodiment.
  • Exemplary eleventh embodiment provisional tibial prosthesis system 30K includes tibial bearing component 32K, base component 34K, rotating knob 36K, medial tapered pin 37K, and lateral tapered pin 39K.
  • Rotating knob 36K is movably connected with medial tapered pin 37K and lateral tapered pin 39K via connecting rod 4 IK.
  • rotating knob 36K, medial tapered pin 37K, lateral tapered pin 39K, and connecting rod 4 IK are each positioned between tibial bearing
  • Base component superior surface 84K includes corresponding curved medial groove 85K and curved lateral groove 87K which respectively correspond to curved medial groove 65K and curved lateral groove 67K of tibial bearing component 32K to create receiving hole 290K which receives medial tapered pin 37K, lateral tapered pin 39K, and connecting rod 4 IK.
  • FIG. 18A portion 43K of rotating knob 36K is exposed from tibial bearing component 32K to allow knob 36K to be rotated in a clockwise direction or a counterclockwise direction.
  • Figs. 18A and 18B the use of exemplary eleventh embodiment 3 OK will now be described.
  • knob 36K is rotated in a first direction, both medial tapered pin 37K and lateral tapered pin 39K are rotated in receiving hole 290K in a direction towards knob 36K.
  • medial tapered pin 37K and lateral tapered pin 39K are tapered such that the end of both medial tapered pin 37K and lateral tapered pin 39K farthest from knob 36K has a diameter greater than the end of medial tapered pin 37K and lateral tapered pin 39K which is closest to knob 36K. For this reason, as knob 36K rotates medial tapered pin 37K and lateral tapered pin 39K toward knob 36K, the end of medial tapered pin 37K and lateral tapered pin 39K which has the greatest diameter is moved inward towards knob 36K to move tibial bearing component 32K away from base component 34K.
  • knob 36K rotation of knob 36K in a second direction, opposite the first direction, will cause medial tapered pin 37K and lateral tapered pin 39K to rotate in a direction away from knob 36K to decrease the distance between tibial bearing component 32K and base component 34K.

Abstract

The present disclosure provides a provisional tibial prosthesis system (30A) for a set of prosthetic knee joints for implantation in a natural knee, the provisional tibial prosthesis system including a bearing component (32A) and a bearing support (34A, 38A), the spacing (36A) of the bearing component from the bearing support is adjustable to allow for representation of a variety of different sized final tibial prostheses. In this system, only one provisional bearing component corresponding to each level of constraint is needed and shims (e.g. 36A) are used to adjust the spacing of the bearing component from the bearing support. The shims are slidably insertable between the bearing component and the bearing support in an anterior/posterior direction to allow for adjustment of the spacing of the bearing component from the bearing support. The number of provisional components needed during knee surgery is reduced and adjustment of the system only requires the knee joint to be distracted by a distance equal to the height of a particular shim.

Description

PROVISIONAL TIBIAL PROSTHESIS SYSTEM
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application claims priority to U.S. Provisional Patent Application Ser. No.
61/424,222, filed December 17, 2010, the entire disclosure of which is hereby expressly incorporated by reference herein.
BACKGROUND
1. Field of the Disclosure.
[0002] The present disclosure relates generally to provisional orthopedic components used to replicate final orthopedic components during a surgical procedure. More particularly, the present disclosure relates to provisional tibial components that assist in determining the proper size of a final tibial prosthesis for a prosthetic knee joint for replacement of all or part of a natural knee.
2. Description of the Related Art.
[0003] Knee replacement provisional components are positioned on a distal femur and/or a proximal tibia to allow range of motion testing so that a surgeon can verify proper sizing of final prosthetic components. Knee replacement systems may include a wide variety of tibial bearing components, including bearing components which cooperate to form a posterior stabilized prosthesis, a cruciate retaining knee prosthesis or a knee prosthesis having an intermediate level of constraint between a posterior stabilized and cruciate retaining prosthesis. Such systems include a high number of provisional components corresponding to the differing constraint levels offered by the system as well as the different sized bearings for each constraint level. During knee surgery, a surgeon may remove and replace a provisional tibial bearing component of a first size with a provisional tibial bearing component of a second size to adjust the ligament tension of the knee joint. Efforts have been made to lessen the number of provisional components needed during knee surgery, including the use of adjustable tibial components having an adjustable height to allow the adjustable tibial component to mimic a variety of different sized final tibial prostheses. [0004] One such device includes a spacer block positioned between a provisional bearing component and a tibial tray to provide additional spacing of the provisional bearing from the tibial tray. However, these devices require distraction of the knee joint to secure the spacer block to the bearing component and the tibia tray.
SUMMARY
[0005] The present disclosure provides a provisional tibial prosthesis system for a set of prosthetic knee joints for implantation in a natural knee, the provisional tibial prosthesis system including a bearing component and a bearing support, the spacing of the bearing component from the bearing support is adjustable to allow for representation of a variety of different sized final tibial prostheses. In a provisional tibial prosthesis system there is, among other things, a bearing surface that articulates with a femoral prosthesis component. Knee replacement systems may include a wide variety of bearing components, including bearing components which cooperate to form a posterior stabilized prosthesis, a cruciate retaining knee prosthesis or a knee prosthesis having an intermediate level of constraint between a posterior stabilized and cruciate retaining prosthesis. In the system of the present disclosure, instead of a system that includes a high number of provisional components corresponding to the differing constraint levels offered by the system as well as the different sized bearings for each constraint level, only one provisional bearing component corresponding to each level of constraint is needed and shims are used to adjust the spacing of the bearing component from the bearing support. Advantageously, the number of provisional components needed during knee surgery is reduced and adjustment of the system only requires the knee joint to be distracted by a distance equal to the height of a particular shim.
[0006] In one embodiment, the present disclosure includes a plurality of shims slidably insertable between a bearing component and a bearing support in an anterior/posterior direction to allow for adjustment of the spacing of the bearing component from the bearing support.
Advantageously, the present disclosure provides a provisional tibial prosthesis system which can be adjusted without removing the bearing component and the bearing support from the knee joint and only distracting the knee joint a distance equal to the height of a particular shim. In one embodiment, the shims are available in a variety of heights to vary the spacing of the bearing component from the bearing support. In other embodiments, the shims are available in equal heights for shim stacking.
[0007] In one embodiment of the present disclosure, a surgeon can space a bearing component having a bearing component height from a bearing support by sliding a first shim having a first shim height between the bearing component and the bearing support in the anterior/posterior direction, and subsequently perform range of motion testing of the knee joint to verify proper sizing of the provisional tibial prosthesis system. If the provisional tibial prosthesis system is properly sized with the first shim between the bearing component and the bearing support, a first final tibial prosthesis represented by the first shim height and the bearing height can be selected for implantation in the natural knee. If the provisional tibial prosthesis system is not properly sized, the surgeon can remove the first shim from between the bearing component and the bearing support in the anterior/posterior direction, and space the bearing component from the bearing support by sliding a second shim having a second shim height between the bearing component and the bearing support in the anterior/posterior direction. If the provisional tibial prosthesis system is properly sized with the second shim between the bearing component and the bearing support, a second final tibial prosthesis represented by the second shim height and the bearing height can be selected for implantation in the natural knee. In another embodiment, if the provisional tibial prosthesis system is not properly sized with the first shim between the bearing component and the bearing support, a second shim having a second shim height can be used to space the bearing component from the bearing support by sliding the second shim between the bearing component and the bearing support in the anterior/posterior direction with the first shim also between the bearing component and the bearing support. If the provisional tibial prosthesis system is properly sized with the first shim and the second shim between the bearing component and the bearing support, a third final tibial prosthesis represented by the first shim height, the second shim height, and the bearing height can be selected for implantation in the natural knee. This stacking of the shims can be repeated using a variety of shims having equal or varying height.
[0008] The disclosure, in one form thereof, comprises a provisional tibial prosthesis system for a prosthetic knee joint for implantation in a natural knee, the provisional tibial prosthesis system capable of alternatively mimicking the geometry of a first final tibial prosthesis and a second final tibial prosthesis, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the provisional tibial prosthesis system including a tibial base plate having a bone contacting surface and an opposing base plate superior surface; a tibial bearing component having a tibial bearing component height, the tibial bearing component attachable to the tibial base plate, the tibial bearing component height representing the first final tibial prosthesis; and a shim having a shim height, the shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/posterior direction when the tibial base plate and the tibial bearing component are separated by a distance along the proximal/distal axis equal to the shim height, the shim height cooperating with the tibial bearing component height to represent the second final tibial prosthesis.
[0009] The disclosure, in another form thereof, comprises a provisional tibial prosthesis system for a prosthetic knee joint for implantation in a natural knee, the provisional tibial prosthesis system capable of alternatively mimicking the geometry of a first final tibial prosthesis, a second final tibial prosthesis, and a third final tibial prosthesis, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an
anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the provisional tibial prosthesis system including a tibial base plate having a bone contacting surface and an opposing base plate superior surface; a tibial bearing component having a tibial bearing component height, the tibial bearing component attachable to the tibial base plate, the tibial bearing component height representing the first final tibial prosthesis; a first shim having a first shim height, the first shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/posterior direction when the tibial base plate and the tibial bearing component are separated by a first distance along the proximal/distal axis equal to the first shim height, the first shim height cooperating with the tibial bearing component height to represent the second final tibial prosthesis; and a second shim having a second shim height, the second shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/posterior direction when the tibial base plate and the tibial bearing component are separated by a second distance along the proximal/distal axis equal to the first shim height and the second shim height, the first shim height and the second shim height cooperating with the tibial bearing component height to represent the third final tibial prosthesis.
[0010] The disclosure, in a further form thereof, comprises a method of determining a size of a final tibial prosthesis for a prosthetic knee joint for implantation in a natural knee, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the method including: selecting a provisional tibial prosthesis system including a tibial base plate having a bone contacting surface and an opposing base plate superior surface; a tibial bearing component having a tibial bearing component height, the tibial bearing component attachable to the tibial base plate; and a first shim having a first shim height, the first shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/posterior direction when the tibial base plate and the tibial bearing component are separated by a first distance along the proximal/distal axis equal to the first shim height; resecting the proximal tibia to form a resected proximal tibia surface; positioning the bone contacting surface of the tibial base plate on the resected proximal tibia surface; positioning the tibial bearing component on the tibial base plate; and spacing the tibial bearing component from the tibial base plate by sliding the first shim between the tibial base plate and the tibial bearing component in the anterior/posterior direction, without distracting the femur from the tibia a distance greater than the first shim height.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] The above-mentioned and other features and advantages of this disclosure, and the manner of attaining them, will become more apparent and the disclosure itself will be better understood by reference to the following descriptions of embodiments of the disclosure taken in conjunction with the accompanying drawings, wherein: [0012] Fig. 1 is an exploded perspective view of a provisional tibial prosthesis system in accordance with an exemplary first embodiment of the present disclosure;
[0013] Fig. 2A is a plan view of a tibial bearing component of the provisional tibial prosthesis system of Fig. 1;
[0014] Fig. 2B is a front elevation view of the tibial bearing component of Fig. 2A;
[0015] Fig. 2C is a bottom view of the tibial bearing component of Fig. 2A;
[0016] Fig. 2D is a cross-sectional view taken along line 2D-2D of Fig. 2A;
[0017] Fig. 3A is a plan view of a base component of the provisional tibial prosthesis system of Fig. 1;
[0018] Fig. 3B is a front elevation view of the base component of Fig. 3 A;
[0019] Fig. 3C is a side elevation view of the base component of Fig. 3 A;
[0020] Fig. 4A is a plan view of a shim of the provisional tibial prosthesis system of Fig. 1 ;
[0021] Fig. 4B is a front elevation view of the shim of Fig. 4A;
[0022] Fig. 4C is a cross-sectional view taken along line 4C-4C of Fig. 4A;
[0023] Fig. 5 is a perspective view of a tibial base plate of the provisional tibial prosthesis system of Fig. 1;
[0024] Fig. 6 is a perspective view of a knee joint and the provisional tibial prosthesis system of Fig. 1 illustrating a resected proximal tibia surface with the tibial base plate of Fig. 5 attached thereon, the base component of Fig. 3 A positioned on the tibial base plate, the tibial bearing component of Fig. 2A attached to the base component, and a surgical instrument connected to the shim of Fig. 4A, and illustrating axes of the knee joint;
[0025] Fig. 7 is a perspective view of the provisional tibial prosthesis system of Fig. 6 illustrating using the surgical instrument of Fig. 6 to slide the shim between the base component and the tibial bearing component in an anterior/posterior direction;
[0026] Fig. 8 is a perspective view of the provisional tibial prosthesis system of Fig. 6 illustrating the shim between the base component and the tibial bearing component;
[0027] Fig. 9 is an exploded view of a provisional tibial prosthesis system in accordance with an exemplary second embodiment of the present disclosure;
[0028] Fig. 10A is a plan view of a provisional tibial prosthesis system in accordance with an exemplary third embodiment of the present disclosure;
[0029] Fig. 10B is a cross-sectional view taken along line 10B-10B of Fig. 10A; [0030] Fig. IOC is a cross-sectional view taken along line IOC- IOC of Fig. 10A;
[0031] Fig. 11 A is a plan view of a provisional tibial prosthesis system in accordance with an exemplary fourth embodiment of the present disclosure;
[0032] Fig. 1 IB is a front elevation view of the provisional tibial prosthesis system of Fig. 11 A;
[0033] Fig. 12A is an exploded view of a provisional tibial prosthesis system in accordance with an exemplary fifth embodiment of the present disclosure;
[0034] Fig. 12B is a front elevation view of the provisional tibial prosthesis system of Fig. 12A;
[0035] Fig. 12C is a cross-sectional view taken along line 12C-12C of Fig. 12B;
[0036] Fig. 13A is a plan view of a provisional tibial prosthesis system in accordance with an exemplary sixth embodiment of the present disclosure;
[0037] Fig. 13B is a cross-sectional view taken along line 13B-13B of Fig. 13 A;
[0038] Fig. 14 is a partial perspective view of a provisional tibial prosthesis system in accordance with an exemplary seventh embodiment of the present disclosure;
[0039] Fig. 15 is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary eighth embodiment of the present disclosure;
[0040] Fig. 16A is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary ninth embodiment of the present disclosure;
[0041] Fig. 16B is a plan view of the provisional tibial prosthesis system of Fig. 16A;
[0042] Fig. 16C is a cross-sectional view taken along line 16C-16C of Fig. 16B;
[0043] Fig. 17A is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary tenth embodiment of the present disclosure;
[0044] Fig. 17B is a cross-sectional view taken along line 17B-17B of Fig. 17A;
[0045] Fig. 17C is a cross-sectional view taken along line 17C-17C of Fig. 17A;
[0046] Fig. 18A is a perspective view of a provisional tibial prosthesis system in accordance with an exemplary eleventh embodiment of the present disclosure;
[0047] Fig. 18B is a partial cross-sectional view taken along line 18B-18B of Fig. 18 A;
[0048] Fig. 19A is a plan view of a tibial bearing component in accordance with another exemplary embodiment of the present disclosure;
[0049] Fig. 19B is a front elevation view of the tibial bearing component of Fig. 19A; [0050] Fig. 19C is a plan view of a shim in accordance with another exemplary embodiment of the present disclosure;
[0051] Fig. 19D is a front elevation view of the shim of Fig. 19C; and
[0052] Fig. 19E is a cross-sectional view taken along line 19E-19E of Fig. 19A illustrating the shim of Fig. 19C positioned within a recess of the tibial bearing component of Fig. 19A.
[0053] Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate exemplary embodiments of the disclosure, and such exemplifications are not to be construed as limiting the scope of the disclosure in any manner.
DETAILED DESCRIPTION
[0054] The present disclosure provides a provisional tibial prosthesis system for a set of prosthetic knee joints for implantation in a natural knee, the provisional tibial prosthesis system including a bearing component and a bearing support, the spacing of the bearing component from the bearing support is adjustable to allow for representation of a variety of different sized final tibial prostheses.
[0055] The provisional tibial prosthesis system of the present disclosure may be used with a final tibial prosthesis in accordance with the tibial prosthesis described in U.S. Patent
Application Serial No. 61/381,800, filed September 10, 2010, entitled "Tibial Prosthesis Facilitating Rotational Alignment," the entire disclosure of which is hereby expressly incorporated herein by reference. Further, the provisional tibial prosthesis system of the present disclosure may be used with the method and apparatus described in U.S. Patent Application Serial No. 61/424,222, filed December 17, 2010, entitled "User Interface Related to a Surgical Provisional," the entire disclosure of which was previously incorporated herein by reference.
[0056] Fig. 6 illustrates a natural knee comprising proximal tibial T and distal femur F. Fig. 6 depicts a coordinate system of the natural knee including anterior/posterior axis AA-P,
medial/lateral axis AM_L, and proximal/distal axis AP_D. Anterior/posterior axis AA_P corresponds to anterior/posterior direction 20, medial/lateral axis AM-L corresponds to medial/lateral direction 22, and proximal/distal axis AP_D corresponds to proximal/distal direction 24.
Anterior/posterior direction 20, medial/lateral direction 22, and proximal/distal direction 24 are each normal to one another. As used herein, "proximal" refers to a direction generally toward the heart of a patient, and "distal" refers to the opposite direction of proximal, i.e., away from the heart of the patient. Further, as used herein, "anterior" refers to a direction generally toward the front of a patient, and "posterior" refers to the opposite direction of anterior, i.e., toward the back of a patient. As used herein, "medial" refers to a direction generally toward the middle of a patient, and "lateral" refers to the opposite direction of medial, i.e., toward the side of a patient. For purposes of this disclosure, the above-mentioned anatomical references are used in the description of the components of the provisional tibial prosthesis system with reference to a desired operable use of the components in the body.
[0057] While the exemplary embodiments detailed herein are shown and described with regard to a left knee, it will be appreciated that the present disclosure is equally applicable to a right knee configuration.
[0058] The disclosed embodiments of the present disclosure include a tibial bearing component and a base component. For example, as shown in Fig. 1 of an exemplary first embodiment, provisional tibial prosthesis system 30A includes tibial bearing component 32A and base component 34A. Reference numbers for the provisional tibial prosthesis system, the tibial bearing component, and the base component utilize the same numerical reference number combined with different letters to distinguish the exemplary embodiment (i.e., tibial bearing component 32A, 32B, 32C, etc. respectively correspond to the first, second, and third exemplary embodiments, etc.). For the purposes of this disclosure, a reference numeral followed by A-K corresponds to a similar feature between the exemplary first through eleventh embodiments, respectively.
[0059] The common elements between the eleven described exemplary embodiments follow a similar reference number labeling scheme. For example, the first exemplary embodiment, as illustrated in Figs. 2A-2D, includes tibial bearing component 32A generally including tibial bearing component inferior surface 42A, opposing tibial bearing component superior
surface 44A, and tibial bearing component peripheral wall 46A extending from inferior surface 42A to superior surface 44A. Tibial bearing component 32A includes bearing anterior side 48A, bearing posterior side 50A, bearing lateral side 52A, and bearing medial side 54A. Superior surface 44A is adapted to articulate with condyles of a distal femur F (shown in Figs. 6-8), or condyles of a femoral component (not shown) secured to a distal end of a femur. Superior surface 44A includes bearing lateral articular surface 56A in bearing lateral side 52A and bearing medial articular surface 58 A in bearing medial side 54A, with central tibial eminence 60A disposed between bearing articular surfaces 56A, 58A. Referring to Fig. 2A, eminence 60A generally corresponds in shape and size with the natural tibial eminence of a proximal tibial T (shown in Figs. 6-8) prior to resection. Tibial bearing component 32A further includes PCL cutout 62A disposed at posterior side 50A between lateral articular surface 56A and medial articular surface 58 A. PCL cut-out 62 A is sized and positioned to correspond with a posterior cruciate retaining ligament of a knee joint.
[0060] In the exemplary embodiment of Figs. 2A-2D, tibial bearing component 32A is illustrated as a cruciate retaining bearing component though it is contemplated that other tibial bearing components may be utilized in accordance with the present disclosure such as bearing components which cooperate to form a posterior stabilized prosthesis or a knee prosthesis having an intermediate level of constraint between a posterior stabilized and cruciate retaining prosthesis. Tibial bearing component 32A may also be made available in a variety of shapes and sizes to accommodate a variety of knee joints.
[0061] As shown in Figs. 2A-2D, tibial bearing inferior surface 42A of tibial bearing component 32A includes slots 64A, alignment pins 68A, bearing cavity 70A, and bearing nub cavities 72A. As illustrated in Figs. 2B and 2C, slots 64A are exposed at anterior side 48A and extend from anterior side 48A toward posterior side 50A within tibial bearing component 32A in a direction parallel to anterior/posterior axis AA-P. AS shown in Fig. 2B, in an exemplary embodiment, slots 64A have tapering walls 66A. Referring to Figs. 2B and 2C, alignment pins 68A are located between slots 64A at anterior side 48A. Bearing cavity 70A extends from inferior surface 42A towards superior surface 44A and is sized to accept protrusion 96A (shown in Fig. 3 A) of base component 34A. Further, bearing cavity 70A includes bearing nub cavities 72 A which extend on opposing sides of bearing cavity 70 A and are each sized to receive a nub 104A (shown in Fig. 3 A) located on protrusion 96A of base component 34A.
[0062] The first exemplary embodiment, as illustrated in Figs. 3A-3C, also includes base component 34A generally including base component inferior surface 82 A, opposing base component superior surface 84A, and base component peripheral wall 86A extending from inferior surface 82A to superior surface 84A. Base component 34A includes base anterior side 88 A, base posterior side 90 A, base lateral side 92 A, and base medial side 94 A. [0063] Base component 34A includes protrusion 96A extending from superior surface 84A. Protrusion 96A includes nubs 104A which extend on opposing sides of protrusion 96A.
Referring to Fig. 3B, protrusion bottom wall 100A spans the distance between protrusion 96A and superior surface 84A. Further, protrusion 96A and bottom wall 100A define bottom wall indentations 102A between protrusion 96A and superior surface 84A. Base component 34 A also includes notch 106A at posterior side 90A having a generally W-shape, undercut portion 108 A, medial side groove 110A, and lateral side groove 112 A.
[0064] Fig. 5 illustrates tibial base plate 38A according to an exemplary embodiment of the present disclosure. Tibial base plate 38A generally includes base plate superior surface 150A and opposing base plate bone contacting surface 152A. Tibial base plate 38A closely corresponds in size and shape with the resected proximal tibia surface, and includes base plate peripheral wall 156A extending from bone contacting surface 152A to superior surface 150A. Base plate peripheral wall 156A includes raised perimeter 158A and tibial base plate 38A includes base plate anterior side 166A, base plate posterior side 168 A, base plate medial side 170A, and base plate lateral side 172A. Superior surface 150A includes medial condylar portion 160 A and lateral condylar portion 162 A. Base plate 38A further includes PCL cut-out 164A disposed at posterior side 168 A between medial condylar portion 160A and lateral condylar portion 162A to allow a posterior cruciate retaining ligament of a knee joint to pass therethrough. Further, tibial base plate 38A includes boss 174 A having boss medial sides 176 A and boss lateral sides 178 A. Further, an interior recess is formed between inner medial side 176A and inner lateral side 178 A.
[0065] The manner in which tibial base plate 38A is attached to a proximal tibia will now be discussed. The proximal portion of a patient's tibia is resected to provide a substantially flat surface for receipt of bone contacting surface 152 A of tibial base plate 38 A. Once the proximal tibia is resected, tibial base plate 38A is implanted and secured to the resected proximal tibia using standard surgical techniques. For example, conventional features such as a stem and fins may be located on bone contacting surface 152A to affect securement of tibial base plate 38A to a proximal tibia. While tibial base plate 38A is part of the provisional prosthesis system disclosed herein, tibial base plate 38A may also be part of a final prosthesis system, i.e., tibial base plate 38A is the final base plate implanted to a resected proximal tibia. Tibial base plate 38A may also be part of any other tibia contacting implement utilized in knee arthroplasty. For example, tibial base plate 38A could be part of a tibial sizing plate system in accordance with the tibial sizing plate described in U.S. Patent No. 7,850,698, issued December 14, 2010, entitled "Tibial Trialing Assembly and Method of Trialing a Tibial Implant," the entire disclosure of which is hereby expressly incorporated herein by reference. Tibial base plate 38A may also be part of a tibial sizing plate system in accordance with the tibial sizing plate described in two brochures published by Zimmer, Inc., namely the "Zimmer® Patient Specific Instruments, Surgical Techniques for NexGen® Complete Knee Solution" brochure, copyright 2010, and the "Zimmer® NexGen Trabecular Metal Tibial Tray, Surgical Technique" brochure,
copyright 2007 and 2009, the entire disclosures of which are hereby expressly incorporated herein by reference.
[0066] In an exemplary embodiment, as illustrated in Figs. 6-8, base component 34A is secured to tibial base plate 38A by positioning base component inferior surface 82 A on base plate superior surface 150A. Undercut portion 108A (shown in Figs. 3B and 3C) of base component 34A is positioned within raised perimeter 158 A (shown in Fig. 5) of base plate peripheral wall 156A. Raised perimeter 158A acts as a physical barrier to prevent base component 34A from significant relative movement relative to tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20. In this embodiment, base component 34A is movable relative to tibial base plate 38A in proximal/distal direction 24. In one embodiment, base component 34A is sized to have clearance with tibial base plate 38 A, i.e., some movement between base component 34A and tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20 is allowable, but base component 34A and tibial base plate 38A are prohibited from disengagement in medial/lateral direction 22 and
anterior/posterior direction 20.
[0067] In another exemplary embodiment, tibial bearing component 32A is positioned atop tibial base plate 38 A. In such an embodiment, bearing inferior surface 42A (shown in Fig. 2C) of bearing component 32A is positioned within raised perimeter 158A of base plate peripheral wall 156A in a manner similar to the attachment between base component 34A and tibial base plate 38A discussed above. Raised perimeter 158A again acts as a physical barrier to prevent bearing component 32A from significant relative movement relative to tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20. In this embodiment, bearing component 32A is movable relative to tibial base plate 38A in proximal/distal direction 24. In one embodiment, bearing component 32A is sized to have clearance with tibial base plate 38 A, i.e., some movement between bearing component 32A and tibial base plate 38A in medial/lateral direction 22 and anterior/posterior direction 20 is allowable, but bearing component 32A and tibial base plate 38A are prohibited from disengagement in medial/lateral direction 22 and anterior/posterior direction 20.
[0068] For the purposes of this disclosure, any of the disclosed exemplary first through eleventh embodiments are attachable to a tibial base plate such as tibial base plates 38 A, 38B respectively shown in Figs. 5 and 9. It is also contemplated that other tibial base plates having a variety of different sizes and shapes can be used in accordance with the provisional tibial prosthesis systems of the present disclosure.
[0069] Referring to Figs. 1-3C, the attachment of tibial bearing component 32A to base component 34A will now be described. Tibial bearing component 32A is positioned atop base component 34A by positioning protrusion 96A of base component 34A within bearing cavity 70A of tibial bearing component 32A and positioning nubs 104 A of protrusion 96A respectively within bearing nub cavities 72A. In such an embodiment, base component 34A is locked to tibial bearing component 32A in medial/lateral direction 22 when protrusion 96A is received within bearing cavity 70A and base component 34A is locked to tibial bearing component 32A in anterior/posterior direction 20 when nubs 104A are respectively received within nub cavities 72 A. The walls of bearing cavity 70 A provide a physical barrier to prevent significant relative movement between base component 34A and tibial bearing component 32A in medial/lateral direction 22 and the walls of nub cavities 72A provide a physical barrier to prevent significant relative movement between base component 34A and tibial bearing component 32A in anterior/posterior direction 20. When tibial bearing component 32A is positioned atop base component 34A, tibial bearing component 32A is movable relative to base component 34A in proximal/distal direction 24. In this embodiment, as illustrated in Figs. 6-8, base component 34A is secured to tibial base plate 38A and base component 34A is located between tibial bearing component 32A and tibial base plate 38 A. In another embodiment, as discussed above, tibial bearing component 32A can be positioned directly atop tibial base plate 38 A.
[0070] Figs. 4A-4C illustrate shim 36A according to an exemplary embodiment of the present disclosure. Shim 36A generally includes shim inferior surface 122A, opposing shim superior surface 124 A, and shim peripheral wall 126 A extending from inferior surface 122 A to superior surface 124A. Shim peripheral wall 126A defines a shim exterior profile. In one embodiment, the shim exterior profile substantially matches the tibial base plate exterior profile. Shim 36A also includes shim anterior side 128A, shim posterior side 130A, shim lateral side 132A, and shim medial side 134A. As shown in Figs. 4A-4C, shim superior surface 124A includes rails 136A and handle alignment rails 142A. As illustrated in Figs. 4A and 4B, rails 136A extend from anterior side 128A toward posterior side 130A parallel to
anterior/posterior axis AA-P (shown in Fig. 6). In an exemplary embodiment, rails 136A have lead-in edges 140 A and tapered walls 138A. Handle alignment rails 142 A are located between rails 136A at anterior side 128A. Further, between handle alignment rails 142A is shim ramp 148A. Shim 36A also includes shim notch 144A and lead-in walls 146A, i.e., tapering posterior walls, at posterior side 130A for aligning shim 36A and guiding insertion of shim 36A in anterior/posterior direction 20, as will be further described below.
[0071] In an exemplary embodiment, a set of a plurality of shims 36A can be provided to allow for varying levels of adjustment of provisional tibial prosthesis system 30A, i.e., increasing the distance between tibial bearing component 32A and base component 34A by the shim height of a particular shim 36A inserted therebetween. For example, if four different sizes were to be used in the set of shims, the height of the shims could be 1 mm, 2 mm, 3 mm, and 4 mm. In another embodiment, a set of shims could include a plurality of shims having equal sizes for stacking shims. The stacking shims embodiment can also include a plurality of shims having varying heights. It is envisioned that the set of a plurality of different sized shims 36A could include any desired number of different sized shims having any number of shim heights.
[0072] During insertion of shim 36A, as best shown in Figs. 6 and 7, lead-in walls 146A of shim 36A are placed between bearing component 32A and base component 34A and are used to affect separation of bearing component 32A from base component 34A by a distance along proximal/distal axis AP_D equal to a height of shim 36 A. In this manner, lead-in walls 146 A act as a ramp to separate bearing component 32A from base component 34A. Advantageously, the provisional tibial prosthesis system of the present disclosure can be adjusted in a manner requiring the knee joint to only be distracted by a distance equal to the height of shim 36A. In another embodiment, to further help separation of bearing component 32A from base component 34A, bearing component inferior surface 42A (shown in Fig. 2C) at bearing anterior side 48A (shown in Figs. 2A-2C) can include a beveled edge corresponding to lead-in walls 146A of shim 36 A.
[0073] As illustrated in Figs. 6-8, in one exemplary embodiment, shim 36A is slidably receivable between tibial bearing component 32A and base component 34A in anterior/posterior direction 20. The insertion of shim 36A between tibial bearing component 32A and base component 34A in anterior/posterior direction 20 allows tibial bearing component 32A to only be separated from base component 34A by a distance along proximal/distal axis AP_D equal to the height of shim 36A. Also, tibial bearing component 32A and base component 34A of provisional tibial prosthesis system 30A do not have to be removed from the knee joint to insert and remove shims 36 A.
[0074] In an alternative embodiment, base component 34A is not utilized and shim 36A is positioned between bearing component 32A and base plate 38A. In this embodiment, tibial bearing component 32A is positioned atop tibial base plate 38A such that bearing inferior surface 42A (shown in Fig. 2C) of bearing component 32A is positioned within raised perimeter 158A of base plate peripheral wall 156A. Referring to Fig. 5, in such an embodiment, the anterior rail of base plate 38A will be missing to allow shim 36A to be slidably receivable between tibial bearing component 32A and tibial base plate 38A in anterior/posterior direction 20 using lead-in walls 146A of shim 36A to separate tibial bearing component 32A from tibial base plate 38A by a distance along proximal/distal axis AP_D equal to a height of shim 36 A. In this embodiment, shim 36A will have a perimeter configured to allow shim 36A to be positioned to the securement features of base plate 38 A. For example, shim 36A will have a perimeter similar to the perimeter of base component 34A (shown in Fig. 3 A).
[0075] As previously discussed, when tibial bearing component 32A is positioned atop base component 34A, tibial bearing component 32A is movable relative to base component 34A in proximal/distal direction 24. In the exemplary first embodiment, shim 36A takes away this last degree of freedom between tibial bearing component 32A and base component 34A, i.e., when shim 36A is received between base component 34A and tibial bearing component 32A, shim 36A locks tibial bearing component 32A to base component 34A in proximal/distal direction 24, i.e., significant relative movement between tibial bearing component 32A and base component 34A in proximal/distal direction 24 is prevented. [0076] The manner in which shim 36A locks tibial bearing component 32A to base component 34A in proximal/distal direction 24 will now be discussed. Referring to Figs. 6-8, shim 36A is inserted between tibial bearing component 32A and base component 34A in anterior/posterior direction 20. Referring to Figs. 2A-2D and 4A-4C, and 6, shim rails 136A are aligned with respective tibial bearing component slots 64A. Referring to Fig. 4A, rails 136A each include lead-in edge 140 A to guide insertion of rails 136A in slots 64 A. The rail/slot connection between shim 36A and tibial bearing component 32A is important because it prevents lift-off of tibial bearing component 32A from shim 36A, i.e., prevents significant relative movement between tibial bearing component 32A and shim 36A in proximal/distal direction 24. In one exemplary embodiment, as shown in Figs. 2A-2D and 4A-4C, slots 64A of tibial bearing component 32A and rails 136A of shim 36A each have a dovetail cross-sectional shape.
Slots 64A including tapering walls 66A of bearing component 32A cooperate with rails 136A having tapering walls 138A of shim 36A to act as a physical barrier to prevent lift-off of the tibial bearing component 32A from shim 36A. In an alternate embodiment, slots 64A of tibial bearing component 32A and rails 136A of shim 36A can each have a T-shaped cross-sectional shape or other various shapes that would provide a physical barrier that would prevent lift-off, i.e., prevent significant relative movement between tibial bearing component 32A and base component 34A in proximal/distal direction 24, or any movement of tibial bearing
component 32A in any direction that is perpendicular to base component 34A.
[0077] Referring to Figs. 3A-4C, as shim 36A is inserted in anterior/posterior direction 20 between tibial bearing component 32A and base component 34A using lead-in walls 146A as discussed above, shim 36A also locks to base component 34A by shim notch 144A formed in shim posterior side 130A attaching to base component 34A by sliding notch 144A in
indentations 102A between protrusion 96A and base component superior surface 84A. This shim connection between shim 36A and base component 34A and the rail/slot connection between shim 36A and tibial bearing component 32A allows shim 36A to lock tibial bearing component 32A to base component 34A in proximal/distal direction 24.
[0078] Referring to Figs. 19A-19E, an alternate embodiment including tibial bearing component 32L and shim 36L is illustrated. Tibial bearing component 32L and shim 36L respectively include similar components to tibial bearing component 32A illustrated in
Figs. 2A-2D and shim 36A illustrated in Figs. 4A-4C. For the sake of brevity, these similar components will not all be discussed in conjunction with the alternate embodiments disclosed in Figs. 19A-19E. Referring to Figs. 19A and 19B, tibial bearing component 32L includes recess 78L extending from bearing component inferior surface 42L towards bearing component superior surface 44L. Recess 78L is sized to receive shim 36L (shown in Figs. 19C and 19D). Fig. 19E illustrates shim 36L received in recess 78L of tibial bearing component 32L. Referring to Figs. 19A and 19C, shim rails 136L are aligned with respective tibial component slots 64L. Rails 136L of shim 36L each include lead-in edge 140L to guide insertion of rails 136L in slots 64L of tibial bearing component 32L. Shim 36L is inserted in recess 78L of tibial bearing component 32L in anterior/posterior direction 20 (shown in Fig. 6). In one embodiment, the height of shim 36L is equal to the height of recess 78L of tibial bearing component 32L. In other embodiments, the height of shim 36L could be less than the height of recess 78L. In this embodiment, shim 36L locks tibial bearing component 32L to shim 36L in proximal/distal direction 24 (shown in Fig. 6) without spacing tibial bearing component 32L from a base component, i.e., either base component 34A (shown in Figs. 3A-3C), tibial base plate 38A (shown in Fig. 5), or other tibia contacting implement utilized in knee arthroplasty.
[0079] Before shim 36L is inserted between tibial bearing component 32L and base component 34A (shown in Figs. 3A-3C), tibial bearing component 32L is positioned on base component 34A. With tibial bearing component 32L positioned on base component 34A, recess 78L spaces tibial bearing component 32L from base component 34A a distance along
proximal/distal axis AP_D (shown in Fig. 6) at least equal to the height of shim 36L. Referring to Figs. 3A-3C, 19A and 19E, in one embodiment, tibial bearing component 32L can be positioned on base component 34A by positioning protrusion 96A of base component 34A within bearing cavity 70L of tibial bearing component 32L and positioning nubs 104A of protrusion 96A respectively within bearing nub cavities 72L. Subsequently, shim 36L can be inserted between tibial bearing component 32L and base component 34A in anterior/posterior direction 20 (shown in Fig. 6). With shim 36L inserted within recess 78L of tibial bearing component 32L, shim 36L prevents significant relative movement between tibial bearing component 32L and base component 34A in proximal/distal direction 24 (shown in Fig. 6) without spacing tibial bearing component 32L from base component 34A. Referring to Figs. 19B and 19E, because shim 36L is received in recess 78L of tibial bearing component 32L, the height of shim 36L cooperates with the height of tibial bearing component 32L to represent a first final tibial prosthesis without shim 36L adding to the height of tibial bearing component 32L.
[0080] Referring to Figs. 6-8, an illustrative procedure in accordance with the present disclosure to determine the size of a final tibial prosthesis for a prosthetic knee joint for implantation in a natural knee will now be described. In one embodiment, a surgeon selects a provisional tibial prosthesis system, such as provisional tibial prosthesis system 3 OA, having tibial base plate 38A (shown in Fig. 5) having bone contacting surface 152A and opposing base plate superior surface 150A, tibial bearing component 32A having a tibial bearing component height, tibial bearing component 32A attachable to tibial base plate 38A, and shim 36A having a shim height, shim 36A slidably receivable between tibial base plate 38A and tibial bearing component 32A in anterior/posterior direction 20 when tibial base plate 38A and tibial bearing component 32A are separated by a distance along proximal/distal axis AP_D equal to the shim height.
[0081] Next, the proximal portion of a patient's tibia is resected using standard surgical techniques to provide a substantially flat surface for receipt of bone contacting surface 152A of tibial base plate 38 A. Once the proximal tibia is resected, tibial base plate 38A is implanted and secured to the resected proximal tibia. Subsequently, tibial bearing component 32A
corresponding to the constraint level chosen by the surgeon is positioned atop tibial base plate 38A such that bearing inferior surface 42A (shown in Fig. 2C) of bearing component 32A is positioned within raised perimeter 158A (shown in Fig. 5) of base plate peripheral wall 156A. If base component 34A is utilized, base component 34A is positioned atop tibial base plate 38A between bearing component 32A and base plate 38 A.
[0082] The surgeon can then perform range of motion testing of the knee joint to verify proper sizing of the provisional tibial prosthesis system. If a surgeon determines that a provisional tibial prosthesis system is properly sized with tibial bearing component 32A positioned atop tibial base plate 38 A, a first final tibial prosthesis can be selected which corresponds to the height of tibial bearing component 32A. If the provisional tibial prosthesis system is determined to not be properly sized, tibial bearing component 32A can be spaced from tibial base plate 38A by sliding shim 36A having a first shim height, e.g., 1 mm, between tibial base plate 38A and tibial bearing component 32A in anterior/posterior direction 20. [0083] The surgeon can then perform range of motion testing of the knee joint to verify proper sizing of the provisional tibial prosthesis system with shim 36A having a first shim height inserted between tibial bearing component 32A and tibial base plate 38 A. If the provisional tibial prosthesis system is determined by the surgeon to be properly sized with shim 36A having first shim height between bearing component 32A and tibial base plate 38 A, the surgeon can select a second final tibial prosthesis represented by the first shim height and the tibial bearing component height.
[0084] In one embodiment, if the provisional tibial prosthesis system is not properly sized after insertion of shim 36A having the first shim height, e.g., 1 mm, the 1 mm shim 36A can be removed in anterior/posterior direction 20, another shim 36A may be selected having a second height, e.g., 2 mm, and tibial bearing component 32A can then be spaced from tibial base plate 38A by sliding shim 36A having the second shim height between tibial base plate 38A and tibial bearing component 32A in anterior/posterior direction 20. If the provisional tibial prosthesis system is determined by the surgeon to be properly sized with shim 36A having second shim height, e.g., 2 mm, the surgeon can select a third final tibial prosthesis represented by the second shim height and the tibial bearing component height.
[0085] In an alternate embodiment, after inserting shim 36A having a first shim height, e.g., 1 mm, if a surgeon determines that the provisional tibial prosthesis system with shim 36A having the first shim height is not properly sized, shim 36A having a height of 1 mm can be left between tibial base plate 38A and tibial bearing component 32A, and a second shim 36A having a second shim height, e.g., 1 mm, can be inserted in anterior/posterior direction 20 between tibial base plate 38A and tibial bearing component 32A to separate tibial bearing component 32A from tibial base plate 38A by a distance along proximal/distal axis AP_D equal to the first shim height and the second shim height. In this embodiment, shim 36A may not include either the securement features discussed above that lock shim 36A to tibial bearing component 32A or the securement features discussed above that lock shim 36A to base component 34A. For example, referring to Figs. 4A and 4B, shim 36A may not include rails 136A so that tibial bearing component 32A can move relative to shim 36A in proximal/distal direction 24 (shown in Fig. 6) when shim 36A is inserted between base plate 38A and bearing component 32A. In this manner, a second shim can be inserted in anterior/posterior direction 20 between base plate 38A and bearing component 32A with a first shim already positioned between base plate 38 A and bearing component 32A.
[0086] If the provisional prosthesis system is determined by the surgeon to be properly sized with both shims 36A inserted, the surgeon can select a third final tibial prosthesis represented by the first shim height, the second shim height, and the tibial bearing component height. This stacking of the shims can be repeated using a variety of different sized shims and a variety of different numbered shims for a surgeon to determine the proper thickness of a provisional tibial prosthesis system. In an alternative embodiment, several shims all having the same height can be used in series to adjust the spacing of bearing component 32A from base plate 38 A.
[0087] Referring to Figs. 6-8, the use of surgical instrument 180 to insert shim 36A will now be described. Figs. 6-8 illustrate surgical instrument 180 for insertion or removal of shim 36A. Surgical instrument 180 generally includes handle body 182, handle end 184, opposing attachment end 186, alignment pins 188, tooth 190, button 192, and handle pegs 194. Surgical instrument 180 has one alignment pin 188 on each side of tooth 190. Alignment pins 188 fit in respective exterior circular recesses in rails 142A (shown in Fig. 4B) of shim 36A to properly align surgical instrument 180 to shim 36A. Once properly aligned, tooth 190 of surgical instrument 180 slides along shim ramp 148A (shown in Figs. 4A and 4B) and, when tooth 190 slides past shim ramp 148 A, a biasing force on tooth 190 causes tooth 190 to travel downward and engage the backside of shim ramp 148A to lock surgical instrument 180 to shim 36A. In one embodiment, a biasing force is exerted on tooth 190 by a tension spring. When surgical instrument 180 is properly locked to shim 36A, a surgeon holding handle end 184 of surgical instrument 180 can insert shim 36A in anterior/posterior direction 20 between tibial bearing component 32A and tibial base plate 38A to space tibial bearing component 32A from tibial base plate 38A along proximal/distal axis AP_D a distance equal to the shim height. Once shim 36A is properly inserted between tibial bearing component 32A and tibial base plate 38 A, release button 192 of surgical instrument 180 can be depressed to overcome the biasing force of the spring to release and disengage tooth 190 from the backside of shim ramp 148 A. Thereafter, surgical instrument 180 can be removed. In another embodiment, surgical instrument 180 can be used in the manner described above to insert shim 36A in anterior/posterior direction 20 between tibial bearing component 32A and base component 34A. Also, surgical instrument 180 may be used to remove shim 36A from between tibial bearing component 32A and base component 34A. [0088] Once the proximal portion of a patient's tibia is resected and the tibial prosthesis components of the present disclosure are secured to the resected proximal tibia, soft tissue balancing of the knee can be performed. Subsequently, a sizing guide can be attached to the tibial prosthesis components. Similar to the attachment of surgical instrument 180 to shim 36A, the sizing guide can include alignment pins that fit in respective exterior circular recesses in rails 142A (shown in Fig. 4B) of shim 36A to properly align the sizing guide to shim 36A. Once properly aligned, a locking component of the sizing guide can slide along shim ramp 148 A (shown in Figs. 4A and 4B) and, when the locking component slides past shim ramp 148 A, a biasing force on the locking component can cause the locking component to travel downward and engage the backside of shim ramp 148A to lock the sizing guide to shim 36A. Similarly, a cut guide such as a femoral finishing cut guide can be attached to shim 36 A.
[0089] Fig. 9 illustrates an exemplary second embodiment. The several embodiments of the present disclosure include similar components to the embodiment illustrated in Figs. 1-8. For the sake of brevity, these similar components will not all be discussed in conjunction with the various alternative embodiments disclosed herein. Exemplary second embodiment provisional tibial prosthesis system 30B includes tibial bearing component 32B, base component 34B, shim component 36B, and tibial base plate 38B. In one embodiment, tibial bearing component 32B is positioned atop base component 34B in a manner similar to the arrangement of tibial bearing component 32A to base component 34A discussed above. For example, protrusion 96B is similar to protrusion 96A (shown in Figs. 3A-3C), and bearing cavity 70A (shown in Figs. 2C and 2D) is similar to a cavity (not shown) in bearing component inferior surface 42B. Similar to the arrangement of protrusion 96A of base component 34A and bearing cavity 70A of bearing component 32A, bearing component 32B is positioned atop base component 34B by positioning protrusion 96B of base component 34B within a bearing cavity in inferior surface 42B of bearing component 32B to lock bearing component 32B to base component 34B in medial/lateral direction 22 and anterior/posterior direction 20. Similar to the exemplary first embodiment, shim 36B is slidably receivable between tibial bearing component 32B and base component 34B in anterior/posterior direction 20. As in the exemplary first embodiment, a set of different sized shims 36B can be provided to allow for varying levels of adjustment of provisional tibial prosthesis system 30B, i.e., increasing the distance between tibial bearing component 32B and base component 34B by the shim height of a particular shim 36B inserted therebetween. [0090] Referring to Fig. 9, shim superior surface 124B includes lateral alignment bump 139B and medial alignment bump 14 IB which respectively cooperate with lateral alignment bump 116B and medial alignment bump 114B of base component 34B to align shim 36B and guide insertion of shim 36B in anterior/posterior direction 20. During insertion of shim 36B, alignment bumps 139B, 141B are placed between bearing component 32B and respective alignment bumps 114B, 116B of base component 34B and are used to affect separation of bearing component 32B from base component 34B by a distance along proximal/distal axis AP_D equal to a height of shim 36B. Alignment bumps 139B, 141B of shim 36B and alignment bumps 1 14B, 116B of base component 34B each include a protrusion portion on a proximal side and a recessed portion on a distal side.
[0091] In one embodiment, the insertion end of shim 36B could include lead-in walls similar to lead-in walls 146 A (shown in Figs. 4 A and 4C) to act as a ramp to separate bearing component 32B from base component 34B. Further, every embodiment of the present disclosure including a shim component slidably insertable between a bearing component and a bearing support could include an insertion end having a lead-in wall to act as a ramp to separate the bearing component from the bearing support.
[0092] Instead of the rail/slot connection system of the first exemplary embodiment, in the exemplary second embodiment, shim 36B includes locking tabs 137B located at shim anterior side 128B. Upon insertion of shim 36B between tibial bearing component 32B and base component 34B, shim 36B respectively locks shim 36B to tibial bearing component 32B by a first tab 137B engaging in notch 74B of tibial bearing component 32B and locks shim 36B to base component 34B by a second tab 137B engaging base component 34B at anterior side 88B. In this manner, shim 36B takes away the last degree of freedom between tibial bearing component 32B and base component 34B, i.e., when shim 36B is received between base component 34B and tibial bearing component 32B, shim 36B limits movement between tibial bearing component 32B and base component 34B in proximal/distal direction 24. In such an embodiment, a surgeon can grasp tabs 137B to insert or remove shim 36B from bearing component 32B and base component 34B. Alternatively, a surgeon can use a standard surgical instrument for insertion or removal of shim 36B.
[0093] In an alternative embodiment, base component 34B is not utilized and shim 36B is positioned between bearing component 32B and base plate 38B. Referring to Fig. 9, in such an embodiment, the anterior rail of base plate 38B will be missing to allow shim 36B to be slidably receivable between tibial base plate 38B and tibial bearing component 32B in anterior/posterior direction 20.
[0094] In another embodiment, after inserting shim 36B having a first shim height, e.g., 1 mm, if a surgeon determines that the provisional tibial prosthesis system with shim 36B having the first shim height is not properly sized, shim 36B having a height of 1 mm can be left between base plate 38B and tibial bearing component 32B, and a second shim having a second shim height, e.g., 1 mm, can be inserted between base plate 38B and bearing component 32B to separate bearing component 32B from base plate 38B by a distance along proximal/distal axis Ap_D equal to the first shim height and the second shim height. In this embodiment, shim 36B will not include tabs 137B so that bearing component 32B can move relative to shim 36B in proximal/distal direction 24 (shown in Fig. 6) when shim 36B is inserted between base plate 38B and bearing component 32B. In this manner, a second shim can be inserted in anterior/posterior direction 20 between base plate 38B and bearing component 32B with a first shim already positioned between base plate 38B and bearing component 32B. In the embodiment including shim 36B with no tabs 137B, a standard surgical instrument such as forceps can be used for insertion or removal of shim 36B from bearing component 32B and base component 34B.
[0095] Referring to Fig. 9, base component 34B includes apertures 118B. As illustrated in Fig. 9, two apertures 118B are located near lateral portion 92B and two apertures 118B are located near medial portion 94B. Apertures 118B could receive pegs (not shown) extending from base plate superior surface 150B to allow base plate 38B to snap fit together with base component 34B. Base plate 38B includes boss 174B having boss anterior side 175B, boss medial side 176B, boss posterior side 177B, boss lateral side 178B, and boss winged
portions 179B.
[0096] Figs. 1 OA- IOC illustrate an exemplary third embodiment. Exemplary third embodiment provisional tibial prosthesis system 30C includes tibial bearing component 32C, base component 34C, and pin shim component 36C having lateral pin 121C, medial pin 123C, and handle 125C. Tibial bearing component inferior surface 42C includes eight posts 73 C extending in a distal direction therefrom. For example, four posts 73 C are located beneath medial articular surface 58C and four posts 73C extend beneath lateral articular surface 56C. Referring to Fig. 10A, base component 34C includes eight apertures 113C extending through base component 34C from inferior surface 82C to superior surface 84C. For example, four apertures 113C are located in medial portion 94C and four apertures 113C are located in lateral portion 92C. Each aperture 113C receives a single post 73C of tibial bearing component 32C therein to secure tibial bearing component 32C to base component 34C. In the exemplary embodiment, corresponding posts 73C and apertures 113C lock tibial bearing component 32C to base component 34C in medial/lateral direction 22 and anterior/posterior direction 20. In such an embodiment, tibial bearing component 32C is moveable relative to base component 34C in proximal/distal direction 24. However, when provisional tibial prosthesis system 30C is positioned in a knee joint, the knee joint will exert forces in proximal/distal direction 24 to keep tibial bearing component 32C from pulling off base component 34C.
[0097] Referring to Fig. 10B, tibial bearing component inferior surface 42C includes curved lateral groove 75 C and curved medial groove 77C therein, and base component superior surface 84C includes curved lateral groove 115C and curved medial groove 117C therein.
Lateral groove 75 C and lateral groove 115C correspond to form first mating hole portion 200C and medial groove 77C and medial groove 117C correspond to form second mating hole portion 202C. Referring to Fig. 10A, mating hole portion 200C receives pin 121C therein and mating hole portion 202C receives pin 123C therein.
[0098] Referring to Figs. 1 OA- IOC, the use of pin shim 36C to change the thickness of provisional tibial prosthesis system 30C, i.e., the distance between tibial bearing component 32C and base component 34C, will now be described. As shown in Fig. 10A, pins 121C, 123C are slidably received between base component 34C and tibial bearing component 32C, within respective mating hole portions 200C, 202C, in anterior/posterior direction 20. In an exemplary embodiment, mating hole portions 200C, 202C each have a variable mating hole diameter dhi, dh2. In such an embodiment, referring to Fig. 10A, the diameters of mating hole portions 200C, 202C decrease from anterior side 48C to posterior side 50C. For example, mating hole diameter dh2 is greater than mating hole diameter dhi. In this embodiment, the diameter of pins 121C, 123C are equal, i.e., pin diameter dpi is equal to pin diameter dp2. Accordingly, because mating hole diameters dhi, dh2 decrease towards posterior side 50C, the further pin shim 36C is slid within mating hole portions 200C, 202C, the distance between tibial bearing component 32C and base component 34C is increased. [0099] In another exemplary embodiment, referring to Fig. 10A, the diameter of pins 121C, 123C vary and mating hole diameters dhi, dh2 of mating hole portions 200C, 202C remain the same. For example, in such an embodiment, pin diameter dp2 is greater than pin diameter dpi for both pins 121C and 123C. Further, mating hole diameter dhi and dh2 are equal throughout mating hole portions 200C, 202C. In such an embodiment, because the pin diameters of pins 121C, 123C increase in a direction towards handle 125C, the further pin shim 36C is slid within mating hole portions 200C, 202C, the distance between tibial bearing component 32C and base component 34C is increased.
[00100] In another exemplary embodiment, both pin diameters dpi, dp2 of pins 121C, 123C and mating hole diameters dhi, dh2 of mating hole portions 200C, 202C vary. For example, in such an embodiment, pin diameter dp2 is greater than pin diameter dpi for both pins 121C and 123C and mating hole diameter dh2 is greater than mating hole diameter dhi for both mating hole portions 200C, 202C. Such an embodiment allows for the greatest thickness adjustment because not only does the mating hole diameters decrease towards posterior side 50C, the pin diameters increase towards handle 125C. As in the previous two exemplary embodiments, the further pin shim 36C is slid within mating hole portions 200C, 202C, the distance between tibial bearing component 32C and base component 34C is increased.
[00101] In an exemplary embodiment, a set of different sized pin shims 36C can be provided to allow for varying levels of adjustment of provisional tibial prosthesis system 30C, i.e., increasing the distance between tibial bearing component 32C and base component 34C by the diameters of pins 121C, 123C. It is envisioned that the set of different sized pin shims 36C could include any desired number of different sized pin shims 36C having any number of different pin diameters.
[00102] Figs. 11 A and 1 IB illustrate an exemplary fourth embodiment. Exemplary fourth embodiment provisional tibial prosthesis system 30D includes tibial bearing component 32D, base component 34D, and sliding wedge 36D. Base component superior surface 84D includes base component medial alignment bump 114D and base component lateral alignment bump 116D. Tibial bearing component 32D is positioned on base component 34D such that bearing inferior surface 42D is adjacent to base component superior surface 84D as illustrated in Fig. 11B. [00103] Sliding wedge 36D is generally U-shaped and includes tab 137D, lateral alignment bump 139D, medial alignment bump 141D, lateral wing 143D, anterior wedge portion 144D, and medial wing 145D. As illustrated in Fig. 11 A, lateral wing 143D and medial wing 145D each include lead-in edge 140D, which function similarly to lead-in walls 146A as discussed above. Anterior wedge portion 144D includes lateral wing 143D and medial wing 145D extending at opposing sides of anterior wedge portion 144D. Further, tab 137D extends from anterior wedge portion 144D. In an exemplary embodiment, indicia of a particular sized thickness of sliding wedge 36D can be included on tab 137D.
[00104] Sliding wedge 36D can be provided in a variety of different thicknesses to provide for varying levels of adjustment of provisional tibial prosthesis system 30D, i.e., increasing the distance between tibial bearing component 32D and base component 34D. For example, if four different sizes were to be used in the set of sliding wedges 36D, the height of sliding
wedges 36D could be 1 mm, 2 mm, 3 mm, and 4 mm. It is envisioned that the set of different sized sliding wedges 36D could include any desired number of different sized wedges 36D having any number of different wedge heights.
[00105] Referring to Figs. 11 A and 1 IB, the use of sliding wedge 36D to change the thickness of provisional tibial prosthesis system 30D, i.e., the distance between tibial bearing
component 32D and base component 34D, will now be described. In use, sliding wedge lateral alignment bump 139D and sliding wedge medial alignment bump 14 ID are respectively aligned with base component lateral alignment bump 116D and base component medial alignment bump 114D to properly orientate sliding wedge 36D between tibial bearing component 32D and base component 34D. Once properly aligned, lead-in edges 140D of sliding wedge 36D are placed between tibial bearing component 32D and base component 34D to effect separation of bearing component 32D from base component 34D and wedge 36D is slidably inserted between base component 34D and tibial bearing component 32D in anterior/posterior direction 20.
Alignment bumps 139B, 141D of sliding wedge 36D include a protrusion portion on a proximal side and a recessed portion on a distal side.
[00106] The shims of the present disclosure can be made of a surgical grade material such as stainless steel, various alloys such as a cobalt-chromium alloy, and various ceramics such as silicon nitride. The shims can also be made of various plastics including polyethylene and polyphenylsulfone. In certain embodiments, the shims of the present disclosure will be disposable after a single use.
[00107] Figs. 12A-12C illustrate an exemplary fifth embodiment. Exemplary fifth
embodiment provisional tibial prosthesis system 30E includes tibial bearing component 32E, upper base component 220E, lower base component 250E, and tapered screws 280E. Upper base component 220E generally includes upper base component inferior surface 222E, opposing upper base component superior surface 224E, upper base component peripheral wall 226E extending from inferior surface 222E to superior surface 224E, anterior side 228E, posterior side 230E, lateral side 232E, and medial side 234E. Tibial bearing component inferior surface 42E includes central notch 6 IE extending from anterior side 48E towards posterior side 50E and having rail 63E extending distally from inferior surface 42E. In the illustrated embodiment, two protuberances 65E extend from side wall 67E into central notch 6 IE at a posterior end of central notch 6 IE.
[00108] Upper base component 220E further includes protruding member 236E extending proximally from superior surface 224E. Protruding member 236E including slot 238E spanning a proximal most portion of protruding member 236E from anterior side 228E to posterior side 230E. Further, protruding member 236E includes side grooves 240E. Tibial bearing component 32E is positionable on upper base component 220E by positioning rail 63E of tibial bearing component 32E within slot 238E of upper base component 220E. This arrangement will also cause protuberances 65E to lock into respective side grooves 240E. In such an embodiment, when tibial bearing component 32E is positioned atop upper base component 220E, tibial bearing component 32E is locked to upper base component 220E in medial/lateral direction 22 and proximal/distal direction 24. Upper base component 220E includes posts 242E extending distally from inferior surface 222E.
[00109] Referring to Fig. 12A, lower base component 250E generally includes lower base component inferior surface 252E, opposing lower base component superior surface 254E, lower base component peripheral wall 256E extending from inferior surface 252E to superior surface 254E, anterior side 258E, posterior side 260E, lateral side 262E, and medial side 264E. Lower base component 250E includes eight apertures 266E spanning from superior surface 254E to inferior surface 252E. Referring to Fig. 12A, upper base component 220E and lower base component 25 OE are positioned together by inserting posts 242E of upper base component 220E in respective apertures 266E of lower base component 250E.
[00110] Inferior surface 222E of upper base component 220E also includes curved lateral groove 244E and curved medial groove 246E, both grooves 244E and 246E being threaded. Further, superior surface 254E of lower base component 250E includes curved lateral groove 268E and curved medial groove 270E, both grooves 268E and 270E being threaded. When upper base component 220E is positioned atop lower base component 250E, curved lateral groove 244E of upper base component 220E and curved lateral groove 268E of lower base component 250E form a first tapered hole 290E (shown in Fig. 12B), and curved medial groove 246E of upper base component 220E and curved medial groove 270E of lower base component 250E form a second tapered hole 290E (shown in Fig. 12B).
[00111] Referring to Figs. 12A-12C, the use of tapered screws 280E to adjust the thickness of provisional tibial prosthesis system 30E, i.e., the distance between upper base component 220E and lower base component 250E, will now be described. Tapered screws 280E generally include external threaded portions 282E and internal female hexagon socket 284E. Tapered screws 280E are threadably inserted into respective tapered holes 290E at anterior side 48E. Tapered screw 280E includes tapered screw diameter dtsi at posterior end 286E and tapered screw diameter dts2 at anterior end 288E, tapered screw diameter dts2 being greater than tapered screw diameter dtsi. Further, referring to Fig. 12C, each tapered hole 290E has tapered hole
diameter dthi at posterior side 50E and tapered hole diameter dth2 at anterior side 48E, tapered hole diameter dth2 being greater than tapered hole diameter dthi. Accordingly, as tapered screws 280E are screwed in an anterior to posterior direction, the distance between upper base component 220E and lower base component 250E is increased.
[00112] Figs. 13A and 13B illustrate an exemplary sixth embodiment. Exemplary sixth embodiment provisional tibial prosthesis system 30F includes tibial bearing component 32F, base component 34F, wedge 36F, moving medial member 300F, moving lateral member 302F, medial base rail 308F, and lateral base rail 31 OF.
[00113] Base component superior surface 84F includes medial base rail 308F and lateral base rail 310F. Medial member 300F includes medial member bottom slot 304F and lateral member 302F includes lateral member bottom slot 306F which respectively correspond to medial base rail 308F and lateral base rail 310F. Slots 304F, 306F are respectively positioned atop rails 308F, 31 OF to secure medial member 300F and lateral member 302F to base component 34F. In an exemplary embodiment, slots 304F, 306F and rails 308F, 310F each have a corresponding dovetail shape and cooperate together to act as a physical barrier to prevent lift-off of medial member 300F and lateral member 302F from base component 34F while allowing medial member 300F and lateral member 302F to move in medial/lateral direction 22 over rails 308F, 310F.
[00114] Wedge component 36F generally includes wedge head portion 37F, wedge handle 39F, wedge medial slot 41F, and wedge lateral slot 43F. Wedge component 36F is attachable to medial member 3 OOF and lateral member 302F by aligning wedge medial slot 4 IF and wedge lateral slot 43F respectively over medial member rail 312F and lateral member rail 314F which allows wedge component 36F to slide in an anterior/posterior direction relative to moving members 300F, 302F. As wedge component 36F is slid in an anterior to posterior direction, wedge head portion 37F pushes medial member 3 OOF and lateral member 302F outward in medial/lateral direction 22 over rails 308F, 310F. In such an embodiment, the inclined surfaces (shown in Fig. 13B) of moving medial member 300F and moving lateral member 302F interface with inferior surface 42F of tibial bearing component 32F causing tibial bearing component 32F to move in a proximal direction away from base component 34F.
[00115] Fig. 14 illustrates an exemplary seventh embodiment. Exemplary seventh embodiment provisional tibial prosthesis system 30G includes tibial bearing component 32G, base component 34G, and gear system 36G. Base component superior surface 84G includes anterior post 95 G, lateral posterior post 97G, and medial posterior post 99G, posts 95 G, 97G, 99G each extending proximally from superior surface 84G.
[00116] Gear system 36G generally includes anterior gear 121G, lateral posterior gear 123G, and medial posterior gear 124G. Posterior gears 123G, 124G include annular incline surfaces 125G located on top of gears 123G, 124G. Further, front anterior gear 121G includes front anterior gear teeth 127G, and posterior gears 123G, 124G each include posterior gear teeth 129G. Referring to Fig. 14, front anterior gear 121G is attached to base component 34G by sliding aperture 131G of front anterior gear 121G over anterior post 95 G of base
component 34G. Similarly, lateral posterior gear 123G is attached to base component 34G by sliding aperture 131G of lateral posterior gear 123G over lateral post 97G of base
component 34G and medial posterior gear 124G is attached to base component 34G by sliding aperture 131G of medial posterior gear 124G over medial posterior post 99G of base component 34G.
[00117] Referring to Fig. 14, the use of gear system 36G to adjust the distance of tibial bearing component 32G from base component 34G will now be described. The portion of front anterior gear 121G exposed from tibial bearing component 32G and base component 34G at anterior side 88G can be turned by a surgeon's finger or a surgical instrument to turn front anterior gear 121G which causes posterior gears 123G, 124G to rotate. Front anterior gear 121G is mechanically connected to posterior gears 123G, 124G by engagement of front anterior gear teeth 127G with rear posterior gear teeth 129G of lateral posterior gear 123G and medial posterior gear 124G. Rotation of posterior gears 123G, 124G causes annular incline
surface 125G of posterior gears 123G, 124G to rotate so the thickest part of annular incline surface 125G starts to contact an inferior surface of tibial bearing component 32G which causes tibial bearing component 32G to move in a proximal direction away from base component 34G.
[00118] Fig. 15 illustrates an exemplary eighth embodiment. Exemplary eighth
embodiment provisional tibial prosthesis system 30H includes tibial bearing component 32H, base component 34H, pry bar 36H, lateral wing 45H, and medial wing 47H. Base component superior surface 84H includes a plurality of steps 85H that are respectively located a distance closer to an inferior surface of tibial bearing component 32H as steps 85H extend inwardly from medial side 54H and lateral side 52H.
[00119] Referring to Fig. 15, the use of exemplary eighth embodiment provisional tibial prosthesis system 30H will now be described. As shown in Fig. 15, pry bar 36H is movably connected to tibial bearing component 32H and base component 34H via support members 41H and pins 43H. In such an embodiment, exerting a force on tab 37H of pry bar 36H pushes up lifting member 39H of pry bar 36H to move tibial bearing component 32H away from base component 34H. As the distance between tibial bearing component 32H and base
component 34H increases via pry bar 36H, spring-loaded lateral wing 45H and medial wing 47H rotate inward towards pry bar 36H to the next step 85H. Lateral wing 45H and medial wing 47H maintain the distance between tibial bearing component 32H and base component 34H created by pry bar 36H. If a greater thickness is desired, tab 37H of pry bar 36H can again be depressed causing lifting member 39H of pry bar 36H to further move tibial bearing component 32H away from base component 34H causing lateral wing 45H and medial wing 47H to again rotate inwards to the next level step 85H. In this manner, lateral wing 45H and medial wing 47H again maintain the distance between tibial bearing component 32H and base component 34H created by pry bar 36H. To reset the distance between tibial bearing component 32H and base component 34H to an initial position, lateral exposed end 49H of lateral wing 45H and medial exposed end 51H of medial wing 47H can be pushed in an outward direction away from pry bar 36H to push lateral wing 45H and medial wing 47H back to the initial position causing tibial bearing component 32H to collapse back to an initial position relative to base component 34H.
[00120] Figs. 16A-16C illustrate an exemplary ninth embodiment. Exemplary ninth embodiment provisional tibial prosthesis system 301 includes tibial bearing component 321, base component 341, threaded cylinder 361, and locking cylinders 371. Referring to Figs. 16A-16C, the use of exemplary ninth embodiment provisional tibial prosthesis system 301 will now be described. Threaded cylinder 361 is positioned between tibial bearing component 321 and base component 341 by threadably attaching threaded cylinder 361 to threaded anterior post 851 extending from base component superior surface 841. Threaded cylinder 361 is attached to tibial bearing component 321 via locking cylinders 371. Referring to Fig. 16C, locking cylinders 371 are securely positioned within threaded cylinder annular groove 391 to threaded cylinder 361, and are also securely positioned within tibial bearing component receiving apertures 631 to tibial bearing component 321. Locking cylinders 371 prohibit relative axial movement between cylinder 361 and bearing component 321 while allowing relative rotational movement between cylinder 361 and bearing component 321. Posts 871, 891 prevent bearing component 321 from rotating relative to base component 341.
[00121] In use, a tool having a hexagonal cross-section can be inserted in internal female hexagon socket 411 of threaded cylinder 361 to rotate threaded cylinder 361 on threaded anterior post 851 of base component 341. As threaded cylinder 361 rotates and moves away from base component 341, tibial bearing component 321 which is connected to threaded cylinder 361 via locking cylinders 371 travels with threaded cylinder 361 in a proximal direction away from base component 341.
[00122] Figs. 17A-17C illustrate an exemplary tenth embodiment. Exemplary tenth embodiment provisional tibial prosthesis system 30J includes tibial bearing component 32J, base component 34J, and component wedge assembly 36J. Component wedge assembly 36J includes wedge head portion 37J having tab 39J exposed from tibial bearing component 32J, lateral wedge 41J, and medial wedge 43J. Wedge head portion 37J, lateral wedge 41J, and medial wedge 43 J form an integral wedge piece that can move in anterior/posterior direction 20 relative to tibial bearing component 32J and base component 34J within tibial bearing component cavity 65 J. Referring to Figs. 17A-17C, the use of exemplary tenth embodiment provisional tibial prosthesis system 30J will now be described. As shown in Figs. 17A and 17C, as tab 39J is pushed in an anterior to posterior direction, teeth 45 J grab a portion of tibial bearing
component 32J to prevent wedge assembly 36J from anterior movement when no force is exerted on tab 39J. As tab 39J of wedge head portion 37J is moved in an anterior to posterior direction, attached lateral wedge 41J and medial wedge 43 J also move within tibial bearing component cavity 65J in the anterior to posterior direction. As wedge head portion 37J is pushed anterior to posterior, the inclined surfaces 47 J of lateral wedge 41J and medial wedge 43 J move tibial bearing component 32J away from base component 34J. To reduce the distance between tibial bearing component 32J and base component 34J, a force is exerted on tab 39J to disengage teeth 45J from bearing component 32J and then tab 39J is pulled back toward anterior side 48J to pull component wedge assembly 36 J from a posterior to anterior direction, thus decreasing the distance between tibial bearing component 32J and base component 34J.
[00123] Figs. 18 A- 18B illustrate an exemplary eleventh embodiment. Exemplary eleventh embodiment provisional tibial prosthesis system 30K includes tibial bearing component 32K, base component 34K, rotating knob 36K, medial tapered pin 37K, and lateral tapered pin 39K. Rotating knob 36K is movably connected with medial tapered pin 37K and lateral tapered pin 39K via connecting rod 4 IK. Further, rotating knob 36K, medial tapered pin 37K, lateral tapered pin 39K, and connecting rod 4 IK are each positioned between tibial bearing
component 32K and base component 34K, and are rotatable relative to tibial bearing
component 32K and base component 34K. Inferior surface 42K of tibial bearing
component 32K includes curved medial groove 65K and curved lateral groove 67K. Base component superior surface 84K includes corresponding curved medial groove 85K and curved lateral groove 87K which respectively correspond to curved medial groove 65K and curved lateral groove 67K of tibial bearing component 32K to create receiving hole 290K which receives medial tapered pin 37K, lateral tapered pin 39K, and connecting rod 4 IK.
[00124] As shown in Fig. 18A, portion 43K of rotating knob 36K is exposed from tibial bearing component 32K to allow knob 36K to be rotated in a clockwise direction or a counterclockwise direction. Referring to Figs. 18A and 18B, the use of exemplary eleventh embodiment 3 OK will now be described. As knob 36K is rotated in a first direction, both medial tapered pin 37K and lateral tapered pin 39K are rotated in receiving hole 290K in a direction towards knob 36K. In such an embodiment, medial tapered pin 37K and lateral tapered pin 39K are tapered such that the end of both medial tapered pin 37K and lateral tapered pin 39K farthest from knob 36K has a diameter greater than the end of medial tapered pin 37K and lateral tapered pin 39K which is closest to knob 36K. For this reason, as knob 36K rotates medial tapered pin 37K and lateral tapered pin 39K toward knob 36K, the end of medial tapered pin 37K and lateral tapered pin 39K which has the greatest diameter is moved inward towards knob 36K to move tibial bearing component 32K away from base component 34K. In the illustrated embodiment, rotation of knob 36K in a second direction, opposite the first direction, will cause medial tapered pin 37K and lateral tapered pin 39K to rotate in a direction away from knob 36K to decrease the distance between tibial bearing component 32K and base component 34K.
[00125] While this disclosure has been described as having exemplary designs, the present disclosure can be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the disclosure using its general principles. Further, this application is intended to cover such departures from the present disclosure as come within known or customary practice in the art to which this disclosure pertains and which fall within the limits of the appended claims.

Claims

WHAT IS CLAIMED IS:
1. A provisional tibial prosthesis system for a prosthetic knee joint for implantation in a natural knee, the provisional tibial prosthesis system capable of alternatively mimicking the geometry of a first final tibial prosthesis and a second final tibial prosthesis, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an
anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the provisional tibial prosthesis system comprising:
a tibial base plate having a bone contacting surface and an opposing base plate superior surface;
a tibial bearing component having a tibial bearing component height, said tibial bearing component attachable to said tibial base plate, said tibial bearing component height representing the first final tibial prosthesis; and
a shim having a shim height, said shim slidable relative to both said tibial base plate and said tibial bearing component to be slidably receivable between said tibial base plate and said tibial bearing component in the anterior/posterior direction when said tibial base plate and said tibial bearing component are separated by a distance along the proximal/distal axis equal to said shim height, said shim height cooperating with said tibial bearing component height to represent the second final tibial prosthesis.
2. The provisional tibial prosthesis system of Claim 1, further comprising:
a base component attachable to said tibial bearing component, said base component positionable between said tibial bearing component and said tibial base plate,
said shim slidably receivable between said tibial bearing component and said base component in the anterior/posterior direction when said base component and said tibial bearing component are separated by said distance along the proximal/distal axis equal to said shim height.
3. The provisional tibial prosthesis system of Claim 2, further comprising a first lock, wherein when said shim is received between said base component and said tibial bearing component, said first lock locks said tibial bearing component to said base component in the proximal/distal direction, whereby significant relative movement between said tibial bearing component and said base component in the proximal/distal direction is prevented.
4. The provisional tibial prosthesis system of Claim 3, further comprising a second lock, wherein when said tibial bearing component is attached to said base component, said second lock locks said tibial bearing component to said base component in the medial/lateral direction and the anterior/posterior direction, whereby significant relative movement between said tibial bearing component and said base component in the medial/lateral direction and the
anterior/posterior direction is prevented.
5. The provisional tibial prosthesis system of Claim 2, wherein:
said base component includes a base component inferior surface, an opposing base component superior surface, and a protrusion extending from said base component superior surface, said base component inferior surface positionable on said tibial base plate superior surface; and
said tibial bearing component includes a tibial bearing component inferior surface and an opposing tibial bearing component superior surface, said tibial bearing component inferior surface having a wall defining a cavity, said cavity sized to accept said protrusion of said base component therein, said cavity sized relative to said protrusion so that said wall cooperates with said protrusion to prevent significant relative movement between said tibial bearing component and said base component in the medial/lateral direction and the anterior/posterior direction.
6. The provisional tibial prosthesis system of Claim 2, wherein:
said tibial bearing component includes a tibial bearing component inferior surface and an opposing tibial bearing component superior surface, said tibial bearing component inferior surface defining a slot; and
said shim includes a shim superior surface, an opposing shim inferior surface, and a rail extending from said shim superior surface, said shim removably attachable to said tibial bearing component by sliding said rail of said shim in said slot of said tibial bearing component in the anterior/posterior direction.
7. The provisional tibial prosthesis system of Claim 1, further comprising a lock, wherein when said tibial bearing component is attached to said tibial base plate, said lock locks said tibial bearing component to said tibial base plate in the medial/lateral direction and the
anterior/posterior direction, whereby significant relative movement between said tibial bearing component and said tibial base plate in the medial/lateral direction and the anterior/posterior direction is prevented.
8. The provisional tibial prosthesis system of Claim 7, wherein said slot of said tibial bearing component and said rail of said shim each have a dovetail cross-sectional shape.
9. The provisional tibial prosthesis system of Claim 7, wherein said slot of said tibial bearing component and said rail of said shim each have a T-shaped cross-sectional shape.
10. The provisional tibial prosthesis system of Claim 1, wherein:
said base component includes a base component inferior surface, an opposing base component superior surface, and a protrusion extending from said base component superior surface, said protrusion defining an indentation between said protrusion and said base component superior surface, said base component inferior surface positionable on said tibial base plate superior surface; and
said shim includes a shim superior surface, an opposing shim inferior surface, a shim anterior side, and a shim posterior side, said shim defining a notch formed in said shim posterior side, said notch spanning said shim superior surface and said shim inferior surface, said shim removably attachable to said base component by sliding said indentation of said base component in said notch of said shim in the anterior/posterior direction.
11. A provisional tibial prosthesis system for a prosthetic knee joint for implantation in a natural knee, the provisional tibial prosthesis system capable of alternatively mimicking the geometry of a first final tibial prosthesis, a second final tibial prosthesis, and a third final tibial prosthesis, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the provisional tibial prosthesis system comprising:
a tibial base plate having a bone contacting surface and an opposing base plate superior surface;
a tibial bearing component having a tibial bearing component height, said tibial bearing component attachable to said tibial base plate, said tibial bearing component height representing the first final tibial prosthesis;
a first shim having a first shim height, said first shim slidable relative to both said tibial base plate and said tibial bearing component to be slidably receivable between said tibial base plate and said tibial bearing component in the anterior/posterior direction when said tibial base plate and said tibial bearing component are separated by a first distance along the proximal/distal axis equal to said first shim height, said first shim height cooperating with said tibial bearing component height to represent the second final tibial prosthesis; and
a second shim having a second shim height, said second shim slidable relative to both said tibial base plate and said tibial bearing component to be slidably receivable between said tibial base plate and said tibial bearing component in the anterior/posterior direction when said tibial base plate and said tibial bearing component are separated by a second distance along the proximal/distal axis equal to said first shim height and said second shim height, said first shim height and said second shim height cooperating with said tibial bearing component height to represent the third final tibial prosthesis.
12. The provisional tibial prosthesis system of Claim 11, further comprising:
a base component attachable to said tibial bearing component, said base component positionable between said tibial bearing component and said tibial base plate,
said first shim slidably receivable between said tibial bearing component and said base component in the anterior/posterior direction when said base component and said tibial bearing component are separated by said first distance along the proximal/distal axis equal to said first shim height, and said second shim slidably receivable between said tibial bearing component and said base component in the anterior/posterior direction when said base component and said tibial bearing component are separated by said second distance along the proximal/distal axis equal to said first shim height and said second shim height.
13. The provisional tibial prosthesis system of Claim 12, further comprising a lock, wherein when said tibial bearing component is attached to said base component, said lock locks said tibial bearing component to said base component in the medial/lateral direction and the
anterior/posterior direction, whereby significant relative movement between said tibial bearing component and said base component in the medial/lateral direction and the anterior/posterior direction is prevented.
14. The provisional tibial prosthesis system of Claim 11, further comprising a lock, wherein when said tibial bearing component is attached to said tibial base plate, said lock locks said tibial bearing component to said tibial base plate in the medial/lateral direction and the
anterior/posterior direction, whereby significant relative movement between said tibial bearing component and said tibial base plate in the medial/lateral direction and the anterior/posterior direction is prevented.
15. A method of determining a size of a final tibial prosthesis for a prosthetic knee joint for implantation in a natural knee, the natural knee comprising a proximal tibia and a distal femur and having a medial/lateral axis, an anterior/posterior axis, and a proximal/distal axis, the medial/lateral axis corresponding to a medial/lateral direction, the anterior/posterior axis corresponding to an anterior/posterior direction, and the proximal/distal axis corresponding to a proximal/distal direction, the method comprising:
selecting a provisional tibial prosthesis system, comprising:
a tibial base plate having a bone contacting surface and an opposing base plate superior surface;
a tibial bearing component having a tibial bearing component height, the tibial bearing component attachable to the tibial base plate; and a first shim having a first shim height, the first shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/posterior direction when the tibial base plate and the tibial bearing component are separated by a first distance along the proximal/distal axis equal to the first shim height;
resecting the proximal tibia to form a resected proximal tibia surface;
positioning the bone contacting surface of the tibial base plate on the resected proximal tibia surface;
positioning the tibial bearing component on the tibial base plate; and
spacing the tibial bearing component from the tibial base plate by sliding the first shim between the tibial base plate and the tibial bearing component in the anterior/posterior direction, without distracting the femur from the tibia a distance greater than the first shim height.
16. The method of Claim 15, further comprising:
removing the first shim from between the tibial base plate and the tibial bearing component in the anterior/posterior direction;
said step of selecting the provisional tibial prosthesis system, further comprising the step of:
selecting a second shim having a second shim height, the second shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/posterior direction when the tibial base plate and the tibial bearing component are separated by a second distance along the
proximal/distal axis equal to the second shim height, the second shim height different than the first shim height; and
spacing the tibial bearing component from the tibial base plate by sliding the second shim between the tibial base plate and the tibial bearing component in the anterior/posterior direction, without distracting the femur from the tibia a distance greater than the second shim height.
17. The method of Claim 15, further comprising:
said step of selecting the provisional tibial prosthesis system, further comprising the step of:
selecting a second shim having a second shim height, the second shim slidable relative to both the tibial base plate and the tibial bearing component to be slidably receivable between the tibial base plate and the tibial bearing component in the anterior/posterior direction when the tibial base plate and the tibial bearing component are separated by a second distance along the proximal/distal axis equal to the first shim height and the second shim height; and spacing the tibial bearing component from the tibial base plate by sliding the second shim between the tibial base plate and the tibial bearing component in the anterior/posterior direction, without distracting the femur from the tibia a distance greater than the first shim height and the second shim height.
PCT/US2011/065683 2010-12-17 2011-12-17 Provisional tibial prosthesis system WO2012083280A1 (en)

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EP11808493.8A EP2651343B1 (en) 2010-12-17 2011-12-17 Provisional tibial prosthesis system
ES11808493.8T ES2622842T3 (en) 2010-12-17 2011-12-17 Temporary tibial prosthesis system
CN201180067430.XA CN103379880B (en) 2010-12-17 2011-12-17 Provisional tibial prosthesis system
AU2011343440A AU2011343440B2 (en) 2010-12-17 2011-12-17 Provisional tibial prosthesis system
EP17157909.7A EP3335674B1 (en) 2010-12-17 2011-12-17 Provisional tibial prosthesis system
CA2824527A CA2824527C (en) 2010-12-17 2011-12-17 Provisional tibial prosthesis system
JP2013544858A JP5559437B2 (en) 2010-12-17 2011-12-17 Tibial prosthesis device

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US61/424,222 2010-12-17
US13/087,610 US8603101B2 (en) 2010-12-17 2011-04-15 Provisional tibial prosthesis system
US13/087,610 2011-04-15

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Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2830543A1 (en) * 2012-03-30 2015-02-04 Zimmer, Inc. Tibial prosthesis systems, kits, and methods
JP2015533608A (en) * 2012-11-07 2015-11-26 ウク カン,ヒョン Femoral component for femoral knee implant system
WO2016026007A1 (en) * 2014-08-21 2016-02-25 Hoe Frederick Knee prosthesis apparatus and methods and instrumentation for implantation thereof
US9763807B2 (en) 2010-12-17 2017-09-19 Zimmer, Inc. Provisional tibial prosthesis system
US9901331B2 (en) 2013-09-23 2018-02-27 Zimmer, Inc. Spacer block
US10010330B2 (en) 2010-12-17 2018-07-03 Zimmer, Inc. Cut guide attachment for use in tibial prosthesis systems
US10195041B2 (en) 2010-07-24 2019-02-05 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US10265181B2 (en) 2011-11-21 2019-04-23 Zimmer, Inc. Tibial baseplate with asymmetric placement of fixation structures
US10278827B2 (en) 2015-09-21 2019-05-07 Zimmer, Inc. Prosthesis system including tibial bearing component
US10413415B2 (en) 2010-09-10 2019-09-17 Zimmer, Inc. Motion facilitating tibial components for a knee prosthesis
US10470889B2 (en) 2010-07-24 2019-11-12 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US10543099B2 (en) 2010-07-24 2020-01-28 Zimmer, Inc. Tibial prosthesis
US10675153B2 (en) 2017-03-10 2020-06-09 Zimmer, Inc. Tibial prosthesis with tibial bearing component securing feature
US10835380B2 (en) 2018-04-30 2020-11-17 Zimmer, Inc. Posterior stabilized prosthesis system
US10898337B2 (en) 2011-11-18 2021-01-26 Zimmer, Inc. Tibial bearing component for a knee prosthesis with improved articular characteristics
US10987232B2 (en) 2016-09-28 2021-04-27 Kyocera Corporation Artificial knee joint replacement operation instrument
US11324599B2 (en) 2017-05-12 2022-05-10 Zimmer, Inc. Femoral prostheses with upsizing and downsizing capabilities
US11324598B2 (en) 2013-08-30 2022-05-10 Zimmer, Inc. Method for optimizing implant designs
US11426282B2 (en) 2017-11-16 2022-08-30 Zimmer, Inc. Implants for adding joint inclination to a knee arthroplasty
US11633294B2 (en) 2019-12-09 2023-04-25 Depuy Ireland Unlimited Company Orthopaedic surgical instrument system having an anterior-loading tibial bearing trial and associated surgical method of using the same

Families Citing this family (94)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8303597B2 (en) 2005-02-08 2012-11-06 Rasmussen G Lynn Systems and methods for guiding cuts to a femur and tibia during a knee arthroplasty
US8317797B2 (en) 2005-02-08 2012-11-27 Rasmussen G Lynn Arthroplasty systems and methods for optimally aligning and tensioning a knee prosthesis
EP1968497B1 (en) 2005-12-15 2016-03-16 Zimmer, Inc. Distal femoral knee prostheses
US8632600B2 (en) * 2007-09-25 2014-01-21 Depuy (Ireland) Prosthesis with modular extensions
US9204967B2 (en) * 2007-09-28 2015-12-08 Depuy (Ireland) Fixed-bearing knee prosthesis having interchangeable components
US20100250276A1 (en) * 2009-03-26 2010-09-30 Jay Pierce System and method for an orthopedic dynamic data repository and registry for clinical
US9011547B2 (en) 2010-01-21 2015-04-21 Depuy (Ireland) Knee prosthesis system
US20130079671A1 (en) * 2011-09-23 2013-03-28 Orthosensor Self-contained muscular-skeletal parameter measurement system having shims to adjust height
GB201006716D0 (en) * 2010-04-22 2010-06-09 Depuy Ireland A composite trial prosthesis
CA2993979A1 (en) 2010-09-10 2012-03-15 Zimmer Gmbh Femoral prosthesis with medialized patellar groove
US8728167B2 (en) 2011-01-10 2014-05-20 Howmedica Osteonics Corp. Bicruciate retaining tibial baseplate design and method of implantation
US11771442B2 (en) * 2011-05-13 2023-10-03 Biomet Manufacturing Llc Bi-cruciate knee system
US8617250B2 (en) 2011-06-17 2013-12-31 Biomet Manufacturing, Llc Revision knee tibial locking mechanism
US8968412B2 (en) 2011-06-30 2015-03-03 Depuy (Ireland) Trialing system for a knee prosthesis and method of use
US8986390B2 (en) * 2011-06-30 2015-03-24 Depuy (Ireland) Method of trialing a knee prosthesis
US8951301B2 (en) * 2011-06-30 2015-02-10 Depuy (Ireland) Method of using a trialing system for a knee prosthesis
GB201114059D0 (en) 2011-08-16 2011-09-28 Depuy Ireland Attachment mechanism
US8911501B2 (en) 2011-12-29 2014-12-16 Mako Surgical Corp. Cruciate-retaining tibial prosthesis
CN102688097B (en) * 2012-05-14 2014-11-26 清华大学 Attitude acquisition method and system for acetabulum and femoral head in artificial hip joint replacement
US8843229B2 (en) * 2012-07-20 2014-09-23 Biomet Manufacturing, Llc Metallic structures having porous regions from imaged bone at pre-defined anatomic locations
CN103565438B (en) * 2012-08-06 2016-03-02 纳通生物科技(北京)有限公司 Ligament balance regulates auxiliary device and knee joint bending thereof and outward turning angle computation method
FR2994644B1 (en) * 2012-08-24 2014-08-29 Anatomic PROTHETIC TIBIAL PLUG AND TIBIAL PROTHETIC INSERT FOR IMMOBILIZATION ON SUCH PROTHETIC TIBIAL PLUG
WO2014127229A1 (en) * 2013-02-14 2014-08-21 Zimmer, Inc. Trialing for prosthetic component
US9345578B2 (en) 2013-02-22 2016-05-24 Stryker Corporation Bicruciate retaining tibial implant system
EP2996634B1 (en) * 2013-05-17 2017-11-01 Brainlab AG Adjustable endoprosthesis
US9427336B2 (en) 2013-08-23 2016-08-30 Stryker Corporation Intraoperative dynamic trialing
FR3010628B1 (en) 2013-09-18 2015-10-16 Medicrea International METHOD FOR REALIZING THE IDEAL CURVATURE OF A ROD OF A VERTEBRAL OSTEOSYNTHESIS EQUIPMENT FOR STRENGTHENING THE VERTEBRAL COLUMN OF A PATIENT
USD748786S1 (en) * 2013-10-16 2016-02-02 Depuy (Ireland) Tibial trial component
FR3012030B1 (en) 2013-10-18 2015-12-25 Medicrea International METHOD FOR REALIZING THE IDEAL CURVATURE OF A ROD OF A VERTEBRAL OSTEOSYNTHESIS EQUIPMENT FOR STRENGTHENING THE VERTEBRAL COLUMN OF A PATIENT
EP2918235B1 (en) * 2013-10-25 2017-01-04 Zimmer, Inc. Cut guide attachment for use in tibial prosthesis systems
KR101606694B1 (en) * 2014-02-14 2016-03-28 주식회사 코렌텍 Tibia prosthesis trial for total knee arthroplasty
TWM479734U (en) * 2014-02-27 2014-06-11 United Orthopedic Corp Stack-up assembly for tibial insert trial
US9861491B2 (en) * 2014-04-30 2018-01-09 Depuy Ireland Unlimited Company Tibial trial system for a knee prosthesis
JP6573908B2 (en) 2014-05-12 2019-09-11 インテグラ・ライフサイエンシーズ・コーポレイションIntegra LifeSciences Corporation Total joint replacement prosthesis
US10130375B2 (en) 2014-07-31 2018-11-20 Zimmer, Inc. Instruments and methods in performing kinematically-aligned total knee arthroplasty
PT3197403T (en) * 2014-09-24 2022-05-02 Depuy Ireland Ultd Co Surgical planning and method
DE102014223701B4 (en) * 2014-11-20 2019-03-07 Siemens Healthcare Gmbh Predictable mobility for a robotic device
US20170340445A1 (en) * 2014-12-05 2017-11-30 Ceramtec Gmbh Ceramic Spacer for the Two-Sided Replacement of Implants in Shoulder, Knee and Hip as a Result of Infections
WO2016153927A1 (en) 2015-03-23 2016-09-29 Zimmer, Inc. Disposable multi-purpose tool for total knee arthroplasty
US10603188B2 (en) 2015-05-29 2020-03-31 Biomet Manufacturing, Llc Bearing trial system
US9668883B2 (en) 2015-08-19 2017-06-06 Depuy Ireland Unlimited Company Trial kit for knee prosthesis system
WO2017058535A1 (en) 2015-09-29 2017-04-06 Zimmer, Inc. Tibial prosthesis for tibia with varus resection
GB2543284A (en) 2015-10-13 2017-04-19 Biomet Uk Healthcare Ltd An anterior locking clip
US10195056B2 (en) 2015-10-19 2019-02-05 Depuy Ireland Unlimited Company Method for preparing a patient's tibia to receive an implant
US10537445B2 (en) 2015-10-19 2020-01-21 Depuy Ireland Unlimited Company Surgical instruments for preparing a patient's tibia to receive an implant
KR101744741B1 (en) 2015-10-21 2017-06-20 주식회사 코렌텍 Knee Combining System
US10456211B2 (en) 2015-11-04 2019-10-29 Medicrea International Methods and apparatus for spinal reconstructive surgery and measuring spinal length and intervertebral spacing, tension and rotation
ES2963827T3 (en) * 2016-04-22 2024-04-02 Jonathan Peter Cabot An arrangement for use in preparing the proximal surface of the tibia for the tibia component of a knee joint prosthesis
WO2017185108A2 (en) * 2016-04-28 2017-11-02 Medfit Beratungs-Und Beteiligunges.M.B.H Dynamic ligament balancing system (dlb)
US10271965B2 (en) * 2016-05-10 2019-04-30 Sterling Innovations, Llc Prosthetic gap references system and method
ITUA20163486A1 (en) * 2016-05-16 2017-11-16 Tecres Spa SPACER DEVICE BOUND BY KNEE
US10470900B2 (en) * 2016-06-17 2019-11-12 Paragon 28, Inc. Implants, devices, systems, kits and methods of implanting
EP3474725A1 (en) 2016-06-24 2019-05-01 Surgical Sensors BVBA Integrated ligament strain measurement
US10231840B2 (en) 2016-07-27 2019-03-19 Howmedica Osteonics Corp. Low profile tibial baseplate with fixation members
CN107753161B (en) * 2016-08-17 2021-09-21 史密夫和内修有限公司 Adjustable position trial component with drill guide
JP6788459B2 (en) * 2016-09-28 2020-11-25 京セラ株式会社 Instrument for total knee arthroplasty
AU2017368252A1 (en) * 2016-11-30 2019-07-18 G. Lynn Rasmussen Systems and methods for providing a tibial baseplate
CN110022798A (en) * 2016-12-06 2019-07-16 捷迈有限公司 Shin bone plug-in unit
WO2018109556A1 (en) 2016-12-12 2018-06-21 Medicrea International Systems and methods for patient-specific spinal implants
US11266512B2 (en) 2016-12-22 2022-03-08 Orthosensor Inc. Surgical apparatus to support installation of a prosthetic component and method therefore
US11185425B2 (en) 2016-12-22 2021-11-30 Orthosensor Inc. Surgical tensor configured to distribute loading through at least two pivot points
US11291437B2 (en) 2016-12-22 2022-04-05 Orthosensor Inc. Tilting surgical tensor to support at least one bone cut
US11399818B2 (en) 2016-12-22 2022-08-02 Orthosensor Inc. Surgical apparatus to support installation of a prosthetic component with reduced alignment error
US11284873B2 (en) 2016-12-22 2022-03-29 Orthosensor Inc. Surgical tensor where each distraction mechanism is supported and aligned by at least two guide shafts
EP3585317B1 (en) * 2017-02-27 2021-06-09 Zimmer, Inc. Prosthetic knee implant systems with linked tibial rotation
WO2018161119A1 (en) 2017-03-07 2018-09-13 Q L Spacer Blocks Pty Ltd A surgical device
KR101954936B1 (en) * 2017-03-23 2019-03-11 주식회사 코렌텍 Detachable Knee Trial
KR20180111304A (en) * 2017-03-31 2018-10-11 에스케이하이닉스 주식회사 Ferroelectric Memory Device
WO2018193317A1 (en) 2017-04-21 2018-10-25 Medicrea International A system for providing intraoperative tracking to assist spinal surgery
FR3067106B1 (en) * 2017-06-06 2019-08-16 Peugeot Citroen Automobiles Sa METHOD FOR THREE-DIMENSIONAL MEASUREMENT OF A UPPER SLIDING SIDE OF A SLIDING SIDE DOOR OF A MOTOR VEHICLE
EP3595545B1 (en) 2017-07-28 2023-12-27 Wright Medical Technology, Inc. Joint osteotomy system
CN107898536A (en) * 2017-11-09 2018-04-13 北京市春立正达医疗器械股份有限公司 Knee-joint prosthesis
US10918422B2 (en) 2017-12-01 2021-02-16 Medicrea International Method and apparatus for inhibiting proximal junctional failure
US11678894B2 (en) 2017-12-15 2023-06-20 Jonathan P. Cabot Knee balancing instrument
US20190240046A1 (en) 2018-02-02 2019-08-08 Orthosoft, Inc. Range of motion evaluation in orthopedic surgery
US20190240045A1 (en) 2018-02-02 2019-08-08 Orthosoft, Inc. Soft tissue balancing in robotic knee surgery
US11065124B2 (en) 2018-05-25 2021-07-20 Howmedica Osteonics Corp. Variable thickness femoral augments
US11660211B2 (en) 2018-10-05 2023-05-30 Orthosensor, Inc. Measurement device for measuring a load magnitude and a position of applied load to a curved surface
AU2019397526A1 (en) 2018-12-13 2021-07-29 Paragon 28, Inc. Alignment instruments and methods for use in total ankle replacement
CN109528364A (en) * 2019-01-31 2019-03-29 北京爱康宜诚医疗器材有限公司 Control system and articular prosthesis with it
US11304826B1 (en) * 2019-02-12 2022-04-19 Smith & Nephew, Inc. Tibial trials with sliding spacers and method
US11877801B2 (en) 2019-04-02 2024-01-23 Medicrea International Systems, methods, and devices for developing patient-specific spinal implants, treatments, operations, and/or procedures
US11925417B2 (en) 2019-04-02 2024-03-12 Medicrea International Systems, methods, and devices for developing patient-specific spinal implants, treatments, operations, and/or procedures
US11432811B2 (en) 2019-05-09 2022-09-06 Mako Surgical Corp. Joint gap balancing lever and methods of use thereof
US11666318B2 (en) 2019-08-30 2023-06-06 Mako Surgical Corp. Distraction device with disposable force sensor pod
WO2021048202A1 (en) * 2019-09-10 2021-03-18 Depuy Ireland Unlimited Company Adjustable tibial trial instrument and orthopaedic surgical method of using the same
US11769251B2 (en) 2019-12-26 2023-09-26 Medicrea International Systems and methods for medical image analysis
DE102020208501A1 (en) * 2020-07-07 2022-01-13 Aesculap Ag Tibial trial implant
US11571309B2 (en) * 2020-09-30 2023-02-07 Depuy Ireland Unlimited Company Orthopaedic surgical instrument system and a method of trialing an orthopaedic prosthetic assembly
USD961079S1 (en) * 2020-10-27 2022-08-16 Depuy Ireland Unlimited Company Tibial protection plate
KR102547173B1 (en) * 2021-02-10 2023-06-23 주식회사 티제이씨라이프 Bearing component for Artificial knee joint
EP4082485B1 (en) * 2021-04-27 2024-01-31 Aesculap AG Tibial trial insert system
EP4082486A1 (en) * 2021-04-27 2022-11-02 Aesculap AG Tibial trial insert system
EP4115852A1 (en) * 2021-07-05 2023-01-11 Aesculap AG Tibial trial insert system

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5395401A (en) * 1991-06-17 1995-03-07 Bahler; Andre Prosthetic device for a complex joint
US5782925A (en) * 1997-11-06 1998-07-21 Howmedica Inc. Knee implant rotational alignment apparatus
EP1132063A2 (en) * 2000-03-08 2001-09-12 Biomedical Engineering Trust Posterior stabilized knee replacement with dislocation prevention features
US20070239165A1 (en) * 2006-03-29 2007-10-11 Farid Amirouche Device and method of spacer and trial design during joint arthroplasty
US20090125114A1 (en) * 2007-10-10 2009-05-14 Biomet Manufacturing Corp. Knee joint prosthesis system and method for implantation
US7850698B2 (en) 2005-02-17 2010-12-14 Zimmer Technology, Inc. Tibial trialing assembly and method of trialing a tibial implant

Family Cites Families (376)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB225347A (en) 1923-10-31 1924-12-04 Frederick Henry Royce Improvements in mounting engines in vehicles
US3774244A (en) 1972-02-08 1973-11-27 Relief Ruptured And Crippled S Knee-joint prosthesis
US4016606A (en) 1975-07-14 1977-04-12 Research Corporation Knee joint prosthesis
US4257129A (en) * 1979-05-21 1981-03-24 Volz Robert G Prosthetic knee joint tibial implant
US4340978A (en) 1979-07-02 1982-07-27 Biomedical Engineering Corp. New Jersey meniscal bearing knee replacement
US4309778A (en) 1979-07-02 1982-01-12 Biomedical Engineering Corp. New Jersey meniscal bearing knee replacement
US4770661A (en) 1982-01-18 1988-09-13 Indong Oh Conversion femoral endoprosthesis
GB2120943B (en) 1982-03-13 1985-04-11 Thackray C F Ltd Knee prosthesis
US4501266A (en) 1983-03-04 1985-02-26 Biomet, Inc. Knee distraction device
SE450336B (en) 1984-11-28 1987-06-22 Branemark Per Ingvar LED PROTES FOR PERMANENT ANCHORING IN THE BONE TISSUE
US4714474A (en) 1986-05-12 1987-12-22 Dow Corning Wright Corporation Tibial knee joint prosthesis with removable articulating surface insert
US4822365A (en) 1986-05-30 1989-04-18 Walker Peter S Method of design of human joint prosthesis
US4963152A (en) 1986-10-27 1990-10-16 Intermedics Orthopedics, Inc. Asymmetric prosthetic tibial component
US4769040A (en) 1986-11-18 1988-09-06 Queen's University At Kingston Tibial prosthesis
US4759767A (en) 1987-08-10 1988-07-26 Dow Corning Wright Corporation Prosthesis for tibial component of knee joint
DE3730175C1 (en) 1987-09-09 1988-09-15 S & G Implants Gmbh Tibial part of a knee joint endoprosthesis
US4795468A (en) 1987-12-23 1989-01-03 Zimmer, Inc. Mechanism and method for locking a bearing insert to the base of a prosthetic implant
US4959071A (en) 1988-02-03 1990-09-25 Biomet, Inc. Partially stabilized knee prosthesis
EP0327495A3 (en) 1988-02-05 1990-05-09 GebràœDer Sulzer Aktiengesellschaft Tibial component of a knee joint prosthesis
US5047058A (en) 1988-04-08 1991-09-10 Smith & Nephew Richards, Inc. System of inserts for the tibial component of a knee prosthesis
US4950298A (en) 1988-04-08 1990-08-21 Gustilo Ramon B Modular knee joint prosthesis
EP0340919B1 (en) 1988-04-08 1992-07-15 SMITH & NEPHEW RICHARDS, INC. A system of inserts for the tibial component of a knee prosthesis
GB8817908D0 (en) 1988-07-27 1988-09-01 Howmedica Tibial component for replacement knee prosthesis
US4944757A (en) 1988-11-07 1990-07-31 Martinez David M Modulator knee prosthesis system
US4919667A (en) 1988-12-02 1990-04-24 Stryker Corporation Implant
US4936853A (en) 1989-01-11 1990-06-26 Kirschner Medical Corporation Modular knee prosthesis
US5061271A (en) 1989-02-27 1991-10-29 Boehringer Mannheim Corporation Tool for separating components of a modular joint prosthesis
US5171283A (en) 1989-07-11 1992-12-15 Biomedical Engineering Trust Compound shape rotating bearing
US5192328A (en) 1989-09-29 1993-03-09 Winters Thomas F Knee joint replacement apparatus
US5059216A (en) 1989-09-29 1991-10-22 Winters Thomas F Knee joint replacement apparatus
JPH0356424U (en) * 1989-10-03 1991-05-30
US5147405A (en) 1990-02-07 1992-09-15 Boehringer Mannheim Corporation Knee prosthesis
JPH03267055A (en) 1990-03-16 1991-11-27 Koshino Nariko Shank side component of artificial knee joint
US5116375A (en) 1990-08-27 1992-05-26 Hofmann Aaron A Knee prosthesis
US5071438A (en) 1990-11-07 1991-12-10 Intermedics Orthopedics, Inc. Tibial prothesis with pivoting articulating surface
CA2078228C (en) 1990-11-14 2000-04-11 Lawrence Pottenger Improved floating bearing prosthetic knee
EP0495340A1 (en) 1991-01-18 1992-07-22 Gebrüder Sulzer Aktiengesellschaft Modular construction kit for the tibial part of a knee joint prosthesis
US5609639A (en) 1991-02-04 1997-03-11 Walker; Peter S. Prosthesis for knee replacement
GB9102633D0 (en) 1991-02-07 1991-03-27 Finsbury Instr Ltd Knee prosthesis
US5236461A (en) 1991-03-22 1993-08-17 Forte Mark R Totally posterior stabilized knee prosthesis
US5197488A (en) 1991-04-05 1993-03-30 N. K. Biotechnical Engineering Co. Knee joint load measuring instrument and joint prosthesis
US5108442A (en) * 1991-05-09 1992-04-28 Boehringer Mannheim Corporation Prosthetic implant locking assembly
US5282868A (en) 1991-06-17 1994-02-01 Andre Bahler Prosthetic arrangement for a complex joint, especially knee joint
US5133758A (en) 1991-09-16 1992-07-28 Research And Education Institute, Inc. Harbor-Ucla Medical Center Total knee endoprosthesis with fixed flexion-extension axis of rotation
DE69123966T2 (en) 1991-10-11 1997-07-10 Essor Soc Civ Surgical prosthesis for the knee joint
US5310480A (en) 1991-10-31 1994-05-10 Uop Processes for the separation of aromatic hydrocarbons from a hydrocarbon mixture
US5470354A (en) 1991-11-12 1995-11-28 Biomet Inc. Force sensing apparatus and method for orthopaedic joint reconstruction
ATE176145T1 (en) 1992-01-14 1999-02-15 Sulzer Orthopaedie Ag MENISCUS PLATFORM FOR ARTIFICIAL KNEE JOINT
CH686611A5 (en) 1992-01-14 1996-05-15 Sulzer Medizinaltechnik Ag Art Royal knee.
GB9201231D0 (en) 1992-01-21 1992-03-11 Howmedica Tibial element for a replacement knee prosthesis
US5275603A (en) 1992-02-20 1994-01-04 Wright Medical Technology, Inc. Rotationally and angularly adjustable tibial cutting guide and method of use
US5246459A (en) 1992-02-24 1993-09-21 Elias Sarmed G Modular tibial support pegs for the tibial component of a prosthetic knee replacement system
US5282861A (en) 1992-03-11 1994-02-01 Ultramet Open cell tantalum structures for cancellous bone implants and cell and tissue receptors
US6102954A (en) 1992-05-18 2000-08-15 Astra Aktiebolag Joint prosthesis and apparatus for preparing the bone prior to fitting of the prosthesis
SE9201557D0 (en) 1992-05-18 1992-05-18 Astra Ab JOINT PROSTHESIS AND APPARATUS FOR PREPARING THE BONE PRIOR TO FITTING OF THE PROSTHESIS
US5824102A (en) 1992-06-19 1998-10-20 Buscayret; Christian Total knee prosthesis
FR2692475B1 (en) 1992-06-19 2000-04-21 Montpellier Chirurgie TOTAL KNEE PROSTHESIS.
US5425775A (en) 1992-06-23 1995-06-20 N.K. Biotechnical Engineering Company Method for measuring patellofemoral forces
US5271737A (en) 1992-09-04 1993-12-21 U.S. Medical Products, Inc. Tibial prosthetic implant with offset stem
US5344460A (en) 1992-10-30 1994-09-06 Encore Orthopedics, Inc. Prosthesis system
US5658342A (en) 1992-11-16 1997-08-19 Arch Development Stabilized prosthetic knee
US5290313A (en) 1992-11-23 1994-03-01 Zimmer, Inc. Offset prosthetic stem extension
ATE197886T1 (en) 1992-12-14 2000-12-15 Biomedical Eng Trust Inc JOINT PROSTHESIS
US5413604A (en) 1992-12-24 1995-05-09 Osteonics Corp. Prosthetic knee implant for an anterior cruciate ligament deficient total knee replacement
JPH06203576A (en) 1992-12-28 1994-07-22 Toshiba Corp Sense-circuit
US5370699A (en) 1993-01-21 1994-12-06 Orthomet, Inc. Modular knee joint prosthesis
US5344461A (en) 1993-02-12 1994-09-06 Zimmer, Inc. Modular implant provisional
FR2702368B1 (en) 1993-03-10 1995-06-09 Medinov Sa Tibial implant for knee prosthesis.
US5387239A (en) 1993-04-19 1995-02-07 Wright Medical Technology, Inc. Adjustable length prosthetic implant
US5405396A (en) 1993-07-01 1995-04-11 Zimmer, Inc. Tibial prosthesis
GB9314832D0 (en) 1993-07-16 1993-09-01 Walker Peter S Prostheses for knee replacement
IT1264820B1 (en) 1993-07-28 1996-10-10 Cremascoli G Srl TOTAL KNEE PROSTHESIS TOTAL KNEE PROSTHESIS
US5364402A (en) 1993-07-29 1994-11-15 Intermedics Orthopedics, Inc. Tibial spacer saw guide
FR2712799B1 (en) 1993-11-22 1996-07-26 Landanger Landos Total knee prosthesis and corresponding modular knee prosthetic set.
US5871541A (en) 1993-11-23 1999-02-16 Plus Endoprothetik, Ag System for producing a knee-joint endoprosthesis
JPH08509895A (en) 1993-11-23 1996-10-22 プラス エンドプロテティク アーゲー Internal artificial knee joint device
WO1995017860A1 (en) 1993-12-30 1995-07-06 Plus Endoprothetik Ag Knee endoprosthesis
US6074425A (en) 1994-01-14 2000-06-13 Biomedical Engineering Trust I Fixed bearing joint endoprosthesis
US5489311A (en) 1994-01-21 1996-02-06 Joint Medical Products Corporation Prosthesis with orientable bearing surface
ATE193643T1 (en) 1994-03-15 2000-06-15 Sulzer Orthopaedie Ag TIBIAL PLATEAU FOR AN ARTIFICIAL KNEE JOINT
JPH09511668A (en) 1994-05-09 1997-11-25 スミス アンド ネフュー リチャーズ インコーポレーテッド Orthopedic prosthesis device
FR2720626B1 (en) 1994-06-03 1996-10-04 Provis Sa Prosthetic set of the knee joint.
FR2721500B1 (en) 1994-06-22 1996-12-06 Euros Sa Femoral implant, in particular for a three-compartment knee prosthesis.
GB9415180D0 (en) 1994-07-28 1994-09-21 Walker Peter S Stabilised mobile bearing knee
US5549688A (en) 1994-08-04 1996-08-27 Smith & Nephew Richards Inc. Asymmetric femoral prosthesis
US5755803A (en) 1994-09-02 1998-05-26 Hudson Surgical Design Prosthetic implant
GB9418492D0 (en) 1994-09-14 1994-11-02 Goodfellow John W Prosthetic knee joint device
FR2726175B1 (en) 1994-10-27 1997-01-31 Impact TIBIAL PROSTHETIC ELEMENT FOR KNEE PROSTHESIS
EP0797417B1 (en) 1994-10-28 2000-01-05 Sulzer Orthopedics Inc. Knee prosthesis with shims
US5571194A (en) 1994-11-14 1996-11-05 Johnson & Johnson Professional, Inc. Femoral augmentation system for artificial knee joint
US5458637A (en) 1994-11-21 1995-10-17 Zimmer, Inc. Orthopaedic base component with modular augmentation block
US5556433A (en) 1994-12-01 1996-09-17 Johnson & Johnson Professional, Inc. Modular knee prosthesis
US6102955A (en) 1995-01-19 2000-08-15 Mendes; David Surgical method, surgical tool and artificial implants for repairing knee joints
US5609641A (en) 1995-01-31 1997-03-11 Smith & Nephew Richards Inc. Tibial prosthesis
CN1179709A (en) 1995-01-31 1998-04-22 史密夫和内修有限公司 Tibial prosthesis
US5609642A (en) 1995-02-15 1997-03-11 Smith & Nephew Richards Inc. Tibial trial prosthesis and bone preparation system
US5609643A (en) 1995-03-13 1997-03-11 Johnson & Johnson Professional, Inc. Knee joint prosthesis
US5613970A (en) 1995-07-06 1997-03-25 Zimmer, Inc. Orthopaedic instrumentation assembly having an offset bushing
FR2736819B1 (en) 1995-07-22 1997-09-19 Bouvet Jean Claude KNEE PROSTHESIS WITH SLIDING PAD INTERPOSED BETWEEN A FEMALE PIECE AND A TIBIAL ELEMENT
US5656785A (en) 1995-08-07 1997-08-12 The Charles Stark Draper Laboratory, Inc. Micromechanical contact load force sensor for sensing magnitude and distribution of loads and tool employing micromechanical contact load force sensor
US5733292A (en) * 1995-09-15 1998-03-31 Midwest Orthopaedic Research Foundation Arthroplasty trial prosthesis alignment devices and associated methods
US5733290A (en) 1995-12-21 1998-03-31 Johnson & Johnson Professional, Inc. Quick-release tibial alignment handle
US5658344A (en) 1995-12-29 1997-08-19 Johnson & Johnson Professional, Inc. Tibial insert reinforcement pin
US5702464A (en) 1996-02-20 1997-12-30 Smith & Nephew Inc. Modular trial tibial insert
US5702463A (en) 1996-02-20 1997-12-30 Smith & Nephew Inc. Tibial prosthesis with polymeric liner and liner insertion/removal instrument
US5871543A (en) 1996-02-23 1999-02-16 Hofmann; Aaron A. Tibial prosthesis with mobile bearing member
FR2747914B3 (en) 1996-04-30 1998-05-15 Raoult Andre PARTIAL KNEE PROSTHESIS
GB9611074D0 (en) 1996-05-28 1996-07-31 Howmedica Surgical apparatus
ATE226053T1 (en) 1996-05-28 2002-11-15 Howmedica Internat S De R L TIBIAL PART FOR A KNEE PROSTHESIS
GB9611060D0 (en) 1996-05-28 1996-07-31 Howmedica Tibial element for a replacment knee prosthesis
US5964808A (en) 1996-07-11 1999-10-12 Wright Medical Technology, Inc. Knee prosthesis
ES2185048T3 (en) 1996-09-11 2003-04-16 Plus Endoprothetik Ag TIBIAL PART OF AN ARTICULAR ENDOPROTESIS OF THE KNEE.
US6004351A (en) 1996-09-14 1999-12-21 Mizuho Ika Kogyo Kabushiki Kaisha Prosthetic knee joint
US5824100A (en) 1996-10-30 1998-10-20 Osteonics Corp. Knee prosthesis with increased balance and reduced bearing stress
AU1178497A (en) 1996-12-09 1998-07-03 Jacques Afriat Complete knee joint prosthesis
US8480754B2 (en) 2001-05-25 2013-07-09 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US8545569B2 (en) 2001-05-25 2013-10-01 Conformis, Inc. Patient selectable knee arthroplasty devices
US20090222103A1 (en) 2001-05-25 2009-09-03 Conformis, Inc. Articular Implants Providing Lower Adjacent Cartilage Wear
US8083745B2 (en) 2001-05-25 2011-12-27 Conformis, Inc. Surgical tools for arthroplasty
US20070233269A1 (en) 2001-05-25 2007-10-04 Conformis, Inc. Interpositional Joint Implant
US8882847B2 (en) 2001-05-25 2014-11-11 Conformis, Inc. Patient selectable knee joint arthroplasty devices
US9603711B2 (en) 2001-05-25 2017-03-28 Conformis, Inc. Patient-adapted and improved articular implants, designs and related guide tools
US8771365B2 (en) 2009-02-25 2014-07-08 Conformis, Inc. Patient-adapted and improved orthopedic implants, designs, and related tools
EP0852934B1 (en) 1997-01-10 2002-07-31 Sulzer Orthopädie AG Tibial tray for an artificial knee joint
CA2226240A1 (en) 1997-01-17 1998-07-17 Ceramtec Ag Fixation of a tibial part on a tibial plate of a knee-joint endoprosthesis
GB2323034B (en) 1997-03-13 2001-07-25 Zimmer Ltd Prosthesis for knee replacement
US5824103A (en) 1997-05-12 1998-10-20 Howmedica Inc. Tibial prosthesis
US5976147A (en) 1997-07-11 1999-11-02 Johnson & Johnson Professional, Inc Modular instrumentation for bone preparation and implant trial reduction of orthopedic implants
US6039764A (en) 1997-08-18 2000-03-21 Arch Development Corporation Prosthetic knee with adjusted center of internal/external rotation
US6258126B1 (en) * 1997-09-09 2001-07-10 Depuy Orthopaedics, Inc. Cushioned joint prosthesis
US6010534A (en) 1997-09-25 2000-01-04 Johnson & Johnson Professional, Inc. Rotatable tibial prosthesis with keyed axial securement
US6325828B1 (en) 1997-12-02 2001-12-04 Rose Biomedical Research Apparatus for knee prosthesis
FR2773059B1 (en) 1997-12-31 2000-06-02 Philippe Legay KNEE PROSTHESIS
US6123729A (en) 1998-03-10 2000-09-26 Bristol-Myers Squibb Company Four compartment knee
FR2777452B1 (en) 1998-04-15 2000-12-15 Aesculap Sa KNEE PROSTHESIS
FR2778332B1 (en) 1998-05-07 2000-09-22 Jacques Philippe Laboureau KNEE PROSTHESIS, UNICOMPARTMENTAL AND ADAPTABLE SKATE
US6090144A (en) 1998-05-12 2000-07-18 Letot; Patrick Synthetic knee system
EP0956836B1 (en) 1998-05-13 2004-07-28 DePuy Products, Inc. Tibial tray with adjustable keel
US6660039B1 (en) 1998-05-20 2003-12-09 Smith & Nephew, Inc. Mobile bearing knee prosthesis
US6428577B1 (en) 1998-05-20 2002-08-06 Smith & Nephew, Inc. Mobile bearing knee prosthesis
US6126692A (en) 1998-06-25 2000-10-03 New York Society For The Relief Of The Ruptured And Crippled Maintaining The Hospital For Special Surgery Retaining mechanism for a modular tibial component of a knee prosthesis
US6080195A (en) 1998-07-08 2000-06-27 Johnson & Johnson Professional, Inc. Rotatable and translatable joint prosthesis with posterior stabilization
US6143034A (en) 1998-07-30 2000-11-07 Sulzer Orthopedics Inc. Implantable hinged knee prosthesis having tibial baseplate
US6623526B1 (en) 1999-01-08 2003-09-23 Corin Limited Knee prosthesis
GB2345446B (en) 1999-01-08 2000-11-22 Corin Medical Ltd A knee prosthesis
US6306172B1 (en) 1999-01-28 2001-10-23 Johnson & Johnson Professional, Inc. Modular tibial insert for prosthesis system
FR2788964B1 (en) 1999-01-28 2001-04-20 Aesculap Sa TIBIAL ANTI-TIPPING INSERT
EP1025818B1 (en) 1999-02-03 2007-04-04 DePuy Products, Inc. Modular joint prosthesis system
US6972039B2 (en) 1999-03-01 2005-12-06 Biomet, Inc. Floating bearing knee joint prosthesis with a fixed tibial post
US6413279B1 (en) 1999-03-01 2002-07-02 Biomet, Inc. Floating bearing knee joint prosthesis with a fixed tibial post
US6206927B1 (en) 1999-04-02 2001-03-27 Barry M. Fell Surgically implantable knee prothesis
GB9914074D0 (en) 1999-06-16 1999-08-18 Btg Int Ltd Tibial component
ES2221610T3 (en) 1999-09-24 2005-01-01 Centerpulse Orthopedics Ltd. PIECE OF TIBIA FOR A PROTESIS OF THE ARTICULATION OF THE KNEE, AND KIT WITH A PIECE OF TIBIA OF THIS TYPE.
US6974481B1 (en) 1999-10-20 2005-12-13 Smith & Nephew, Inc. Tibial trial system
EP1097679B1 (en) 1999-10-29 2004-05-19 Sulzer Orthopädie AG Unicompartmental knee prosthesis
DE59908476D1 (en) 1999-11-09 2004-03-11 Link Waldemar Gmbh Co Knee Prosthesis System
US6379388B1 (en) 1999-12-08 2002-04-30 Ortho Development Corporation Tibial prosthesis locking system and method of repairing knee joint
US6770078B2 (en) 2000-01-14 2004-08-03 Peter M. Bonutti Movable knee implant and methods therefor
US6702821B2 (en) 2000-01-14 2004-03-09 The Bonutti 2003 Trust A Instrumentation for minimally invasive joint replacement and methods for using same
US7635390B1 (en) 2000-01-14 2009-12-22 Marctec, Llc Joint replacement component having a modular articulating surface
WO2001067988A2 (en) 2000-03-16 2001-09-20 Eugene M. Wolf M.D. Inc Total shoulder arthroplasty apparatus
ITVI20000025U1 (en) * 2000-04-07 2001-10-07 Tecres Spa TEMPORARY SPACER DEVICE FOR SURGICAL TREATMENT OF THE KNEE
US6436145B1 (en) 2000-06-02 2002-08-20 Zimmer, Inc. Plug for a modular orthopaedic implant and method for assembly
JP3679315B2 (en) 2000-07-19 2005-08-03 経憲 武井 Knee prosthesis
DE60111253T2 (en) 2000-07-20 2006-04-20 Hayes Medical, Inc., El Dorado Hills RAIL INSERT FROM A BIMETAL FOR APPLICATION IN A KNEE PROSTHESIS
US6558426B1 (en) 2000-11-28 2003-05-06 Medidea, Llc Multiple-cam, posterior-stabilized knee prosthesis
US6942670B2 (en) 2000-12-27 2005-09-13 Depuy Orthopaedics, Inc. Prosthesis evaluation assembly and associated method
US6607559B2 (en) 2001-07-16 2003-08-19 Spine Care, Inc. Trial intervertebral distraction spacers
US7169182B2 (en) 2001-07-16 2007-01-30 Spinecore, Inc. Implanting an artificial intervertebral disc
US7497874B1 (en) 2001-02-23 2009-03-03 Biomet Manufacturing Corp. Knee joint prosthesis
US20020120340A1 (en) 2001-02-23 2002-08-29 Metzger Robert G. Knee joint prosthesis
US7776085B2 (en) 2001-05-01 2010-08-17 Amedica Corporation Knee prosthesis with ceramic tibial component
FR2824260B1 (en) 2001-05-04 2004-01-30 Biomet Merck France IMPROVED TIBIAL PROSTHETIC ELEMENT FOR KNEE PROSTHESIS
US6632225B2 (en) 2001-06-20 2003-10-14 Zimmer, Inc. Method and apparatus for resecting a distal femur and a proximal tibia in preparation for implanting a partial knee prosthesis
EP1269938A1 (en) 2001-06-27 2003-01-02 Waldemar Link (GmbH & Co.) Coupled knee prothesis with rotational bearing
US6953479B2 (en) 2001-07-16 2005-10-11 Smith & Nephew, Inc. Orthopedic implant extension
AU2002348204A1 (en) 2001-11-28 2003-06-10 Wright Medical Technology, Inc. Instrumentation for minimally invasive unicompartmental knee replacement
EP1327424B1 (en) 2002-01-11 2012-09-12 Barry M. Fell Surgically implantable knee prosthesis having medially shifted tibial surface
GB0201149D0 (en) 2002-01-18 2002-03-06 Finsbury Dev Ltd Prosthesis
US20040034432A1 (en) 2002-02-11 2004-02-19 Dean Hughes Mobile bearing tibial base prosthetic devices employing oxidized zirconium surfaces
JP3781186B2 (en) 2002-02-13 2006-05-31 徹 勝呂 Knee prosthesis
FR2835738B1 (en) 2002-02-14 2004-10-01 Jacques Afriat TOTAL KNEE PROSTHESIS
US6942475B2 (en) * 2002-03-13 2005-09-13 Ortho Development Corporation Disposable knee mold
WO2003079940A2 (en) 2002-03-19 2003-10-02 The Board Of Trustees Of The University Of Illinois System and method for prosthetic fitting and balancing in joints
US6923832B1 (en) 2002-03-21 2005-08-02 Trigon Incorporated Revision tibial component
FR2838634B1 (en) 2002-04-19 2004-06-18 Cabinet Boettcher TOTAL KNEE PROSTHESIS
AU2003237813A1 (en) 2002-05-09 2003-11-11 Hayes Medical, Inc. System for establishing the orientation of a modular implant
WO2003099106A2 (en) 2002-05-24 2003-12-04 Medicinelodge, Inc. Modular femoral components for knee arthroplasty
US7771483B2 (en) 2003-12-30 2010-08-10 Zimmer, Inc. Tibial condylar hemiplasty implants, anchor assemblies, and related methods
US7329260B2 (en) 2002-06-28 2008-02-12 Depuy Products, Inc. Kit, guide and method for locating distal femoral resection plane
US20040002767A1 (en) 2002-06-28 2004-01-01 Joseph Wyss Modular knee joint prosthesis
ES2309350T3 (en) 2002-07-11 2008-12-16 Advanced Bio Surfaces, Inc. METHOD AND EQUIPMENT FOR INTERPOSITIONAL ARTROPLASTY.
US7291174B2 (en) 2002-09-09 2007-11-06 Depuy Products, Inc. Prosthetic tibial component with modular sleeve
US7632283B2 (en) 2002-09-30 2009-12-15 Depuy Products, Inc. Modified system and method for intraoperative tension assessment during joint arthroplasty
US7591854B2 (en) 2002-09-30 2009-09-22 Depuy Products, Inc. Apparatus, system and method for intraoperative performance analysis during joint arthroplasty
CA2501041A1 (en) 2002-10-07 2004-04-22 Conformis, Inc. Minimally invasive joint implant with 3-dimensional geometry matching the articular surfaces
CN1780594A (en) 2002-11-07 2006-05-31 康复米斯公司 Methods for determining meniscal size and shape and for devising treatment
JP4148316B2 (en) 2002-11-18 2008-09-10 株式会社神戸製鋼所 Artificial knee joint
JP4095919B2 (en) 2002-12-09 2008-06-04 ジンマー株式会社 Measuring device for total knee replacement surgery
ES2465090T3 (en) 2002-12-20 2014-06-05 Smith & Nephew, Inc. High performance knee prostheses
US7160330B2 (en) 2003-01-21 2007-01-09 Howmedica Osteonics Corp. Emulating natural knee kinematics in a knee prosthesis
US20040153066A1 (en) 2003-02-03 2004-08-05 Coon Thomas M. Apparatus for knee surgery and method of use
US7172597B2 (en) 2003-02-04 2007-02-06 Zimmer Technology, Inc. Provisional orthopedic implant and recutting instrument guide
JP4045194B2 (en) 2003-02-25 2008-02-13 京セラ株式会社 Artificial knee joint
FR2852819B1 (en) 2003-03-28 2008-03-07 Iota TOTAL POSTERO-STABILIZED KNEE PROSTHESIS
US7008454B2 (en) 2003-04-09 2006-03-07 Biomedical Engineering Trust I Prosthetic knee with removable stop pin for limiting anterior sliding movement of bearing
US6986791B1 (en) 2003-04-15 2006-01-17 Biomet Manufacturing Corp. Knee prosthesis with moveable post
FR2854059B1 (en) 2003-04-24 2006-01-27 Aesculap Sa MODULAR PLOT FOR POSTERO-STABILIZED KNEE PROSTHESIS
FR2854792B1 (en) 2003-05-12 2005-09-09 Tornier Sa GAME OF PROTHETIC ELEMENTS FOR A TIBIAL PROTHETIC SET
US7153326B1 (en) 2003-06-19 2006-12-26 Biomet Manufacturing Corp. Method and apparatus for use of an offset stem connection
US7081137B1 (en) 2003-06-23 2006-07-25 Howmedica Osteonics Corp. Knee prosthesis with extended range of motion
AU2004258934B2 (en) 2003-07-17 2010-06-03 Exactech, Inc. Mobile bearing knee prosthesis
US7708782B2 (en) 2003-07-17 2010-05-04 Exactech, Inc. Mobile bearing knee prosthesis
US7547327B2 (en) 2003-10-03 2009-06-16 Howmedica Osteonics Corp. Expandable augment trial
WO2005037147A1 (en) 2003-10-17 2005-04-28 Smith & Nephew, Inc. High flexion articular insert
US7261740B2 (en) 2003-10-29 2007-08-28 Wright Medical Technology, Inc. Tibial knee prosthesis
US7585328B2 (en) 2003-11-06 2009-09-08 Haas Steven B Minimally invasive knee arthroplasty
US7294149B2 (en) 2003-12-05 2007-11-13 Howmedica Osteonics Corp. Orthopedic implant with angled pegs
US7364581B2 (en) 2004-01-14 2008-04-29 Howmedica Osteonics Corp. Variable angle cutting block
EP1722721A1 (en) 2004-01-23 2006-11-22 Massachusetts General Hospital Anterior cruciate ligament substituting knee replacement prosthesis
US7442196B2 (en) 2004-02-06 2008-10-28 Synvasive Technology, Inc. Dynamic knee balancer
US8758355B2 (en) 2004-02-06 2014-06-24 Synvasive Technology, Inc. Dynamic knee balancer with pressure sensing
DE202004003133U1 (en) 2004-02-26 2004-07-29 Aap Implantate Ag Joint replacement tibial plateau
US7753960B2 (en) 2004-02-26 2010-07-13 Omni Life Science, Inc. Modular knee prosthesis
EP1574185B1 (en) 2004-03-09 2012-05-23 Zimmer Technology, Inc. Tibial knee component with a mobile bearing
JP3915989B2 (en) 2004-03-17 2007-05-16 徹 勝呂 Artificial knee joint
US7175666B2 (en) 2004-04-30 2007-02-13 Zimmer Technology, Inc. Modular implant with a micro-motion damper
CN101060815B (en) 2004-06-07 2012-07-18 芯赛斯公司 Orthopaedic implant with sensors
US7731755B2 (en) 2004-06-11 2010-06-08 Depuy Products, Inc. Posterior stabilized mobile bearing knee
CH697473B1 (en) 2004-06-15 2008-10-31 Synthes Gmbh Device for the measurement of force amplitudes and force application points in a total Kniegelenkarthroplastik.
FR2871678B1 (en) 2004-06-17 2006-09-01 Transysteme Sa TOTAL KNEE PROSTHESIS
JP2008504107A (en) 2004-06-28 2008-02-14 アースロサーフィス・インコーポレーテッド Joint surface replacement system
US9237958B2 (en) 2004-06-30 2016-01-19 Synergy Disc Replacement Inc. Joint prostheses
EP1778559B1 (en) 2004-07-20 2017-11-15 Cayenne Medical, Inc. Modular apparatus for sculpting the surface of a joint
US8366782B2 (en) 2004-08-05 2013-02-05 Depuy Products, Inc. Modular orthopaedic implant system with multi-use stems
US20060069436A1 (en) 2004-09-30 2006-03-30 Depuy Spine, Inc. Trial disk implant
US7309363B2 (en) 2004-11-24 2007-12-18 Depuy Products, Inc. Adjustable knee tibial trial insert
US20060142869A1 (en) 2004-12-23 2006-06-29 Gross Thomas P Knee prosthesis
CN2768715Y (en) 2005-01-11 2006-04-05 郑诚功 Improved structural artificial knee joint
US20060161259A1 (en) 2005-01-18 2006-07-20 Cheng-Kung Cheng Knee joint prosthesis
US20060189864A1 (en) * 2005-01-26 2006-08-24 Francois Paradis Computer-assisted hip joint resurfacing method and system
US7488330B2 (en) 2005-01-27 2009-02-10 Depuy Spine, Inc. Modular static intervertebral trial
DE102005009496B4 (en) 2005-03-02 2012-12-20 Mathys Ag Bettlach Knee joint endoprosthesis with intermediate element with differently designed sliding surfaces
US20100100011A1 (en) 2008-10-22 2010-04-22 Martin Roche System and Method for Orthopedic Alignment and Measurement
US20060224244A1 (en) 2005-03-31 2006-10-05 Zimmer Technology, Inc. Hydrogel implant
GB2425315B (en) 2005-04-22 2009-10-07 Ge Healthcare Uk Ltd Water-soluble fluoro-substituted cyanine dyes as reactive fluorescence labelling reagents
GB0510193D0 (en) 2005-05-19 2005-06-22 Mcminn Derek J W Knee prosthesis
US7695519B2 (en) 2005-07-08 2010-04-13 Howmedica Osteonics Corp. Modular tibial baseplate
WO2007007841A1 (en) 2005-07-14 2007-01-18 Saga University Artificial knee joint
US20080288080A1 (en) 2005-08-24 2008-11-20 Kantilal Hastimal Sancheti Knee joint prosthesis
US20080243258A1 (en) 2005-08-24 2008-10-02 Kantilal Hastimal Sancheti Knee Joint Prosthesis
JP4522343B2 (en) * 2005-08-26 2010-08-11 ナカシマプロペラ株式会社 Tensor used for joint replacement
US7413577B1 (en) 2005-09-22 2008-08-19 Howmedica Osteonics Corp. Total stabilized knee prosthesis with constraint
JP2009515610A (en) 2005-11-14 2009-04-16 ポートランド・オルソペーディクス・ピーティーワイ・リミテッド Prosthesis assembly with angle / position adapter
US7766969B2 (en) 2005-12-05 2010-08-03 Zimmer, Inc. Modular progressive implant for a joint articulation surface
US8211181B2 (en) 2005-12-14 2012-07-03 New York University Surface guided knee replacement
US8142509B2 (en) 2006-01-23 2012-03-27 Smith & Nephew, Inc. Patellar components
FR2896684B1 (en) 2006-02-01 2008-09-26 Tornier Soc Par Actions Simplifiee TIBIAL IMPLANT WITH OFFSET SHAFT
TWI434675B (en) 2006-02-06 2014-04-21 Conformis Inc Patient selectable joint arthroplasty devices and surgical tools
US7625407B2 (en) 2006-02-07 2009-12-01 Howmedica Osteonics Corp. Tibial prosthesis with asymmetric articular surfaces
US7842092B2 (en) 2006-03-14 2010-11-30 Mako Surgical Corp. Prosthetic device and system and method for implanting prosthetic device
EP1996122B1 (en) 2006-03-21 2012-11-21 DePuy (Ireland) Moment induced total arthroplasty prosthetic
WO2007109641A2 (en) 2006-03-21 2007-09-27 Conformis, Inc. Interpositional joint implant
US8141437B2 (en) 2006-03-29 2012-03-27 Ortho Sensing Technologies, Llc Force monitoring system
CA2648444C (en) 2006-04-04 2014-03-18 Smith & Nephew, Inc. Trial coupler systems and methods
GR1005477B (en) 2006-04-07 2007-03-26 Total knee arthroplasty consisting in the use of an internal prosthesis composed of a third condylus and a pivoting polyethylene insert
GB0607544D0 (en) 2006-04-13 2006-05-24 Pinskerova Vera Knee prothesis
US7695520B2 (en) 2006-05-31 2010-04-13 Biomet Manufacturing Corp. Prosthesis and implementation system
US7842093B2 (en) 2006-07-18 2010-11-30 Biomet Manufacturing Corp. Method and apparatus for a knee implant
GB0614468D0 (en) 2006-07-21 2006-08-30 Depuy Int Ltd Guide Assembly
US20080051908A1 (en) 2006-08-22 2008-02-28 Laurent Angibaud System and method for adjusting the thickness of a prosthesis
DE102006042829A1 (en) 2006-09-08 2008-03-27 Siebel, Thomas, Dr. knee prosthesis
US7740662B2 (en) 2006-10-13 2010-06-22 Depuy Products, Inc. Mobile/fixed prosthetic knee systems
US20080091273A1 (en) 2006-10-13 2008-04-17 Hazebrouck Stephen A Mobile/fixed prosthetic knee systems
US20080091272A1 (en) 2006-10-13 2008-04-17 Aram Luke J Mobile/fixed prosthetic knee systems
US20080091271A1 (en) 2006-10-13 2008-04-17 Bonitati John A Mobile/fixed prosthetic knee systems
US9278006B2 (en) 2006-10-26 2016-03-08 European Foot Platform Sc Ankle prosthesis with neutral position adjustment
JP5379009B2 (en) * 2006-10-31 2013-12-25 スミス アンド ネフュー インコーポレーテッド Experimental femoral prosthesis and use thereof
US7947082B2 (en) 2006-11-09 2011-05-24 Consensus Orthopedics, Inc. System and method for joint arthroplasty
US20080119938A1 (en) 2006-11-17 2008-05-22 Sang Soo Oh Knee joint prosthesis for bi-compartmental knee replacement and surgical devices thereof
JP5448842B2 (en) 2007-01-10 2014-03-19 バイオメト マニファクチャリング コーポレイション Knee joint prosthesis system and implantation method
US8562616B2 (en) 2007-10-10 2013-10-22 Biomet Manufacturing, Llc Knee joint prosthesis system and method for implantation
CN101347359A (en) 2007-03-30 2009-01-21 德普伊产品公司 Mobile bearing assembly having multiple articulation interfaces
US20090005708A1 (en) 2007-06-29 2009-01-01 Johanson Norman A Orthopaedic Implant Load Sensor And Method Of Interpreting The Same
US8080064B2 (en) 2007-06-29 2011-12-20 Depuy Products, Inc. Tibial tray assembly having a wireless communication device
MY146046A (en) 2007-08-10 2012-06-15 Sancheti Kantilal Hastimal Knee joint prosthesis
US8382846B2 (en) 2007-08-27 2013-02-26 Kent M. Samuelson Systems and methods for providing deeper knee flexion capabilities for knee prosthesis patients
US8273133B2 (en) 2007-08-27 2012-09-25 Samuelson Kent M Systems and methods for providing deeper knee flexion capabilities for knee prosthesis patients
US8470047B2 (en) 2007-09-25 2013-06-25 Depuy (Ireland) Fixed-bearing knee prosthesis
US7628818B2 (en) * 2007-09-28 2009-12-08 Depuy Products, Inc. Fixed-bearing knee prosthesis having interchangeable components
US8128703B2 (en) 2007-09-28 2012-03-06 Depuy Products, Inc. Fixed-bearing knee prosthesis having interchangeable components
US20090088862A1 (en) 2007-09-27 2009-04-02 Kyle Thomas Stem extension and adaptor for use with a knee orthopaedic implant
US8777875B2 (en) 2008-07-23 2014-07-15 Otismed Corporation System and method for manufacturing arthroplasty jigs having improved mating accuracy
KR100901528B1 (en) 2008-01-08 2009-06-08 주식회사 코렌텍 Artificial knee joint apparatus for preventing from damaging ligament
KR100930727B1 (en) 2008-01-08 2009-12-09 주식회사 코렌텍 Artificial knee joint with improved post and improved cam structure
KR100904087B1 (en) 2008-01-08 2009-06-23 주식회사 코렌텍 Artificial knee joint apparatus having curvature on a bearing component
CN201175391Y (en) 2008-01-17 2009-01-07 四川大学 Knee joint endoprosthesis
CN101214175B (en) 2008-01-17 2011-03-23 四川大学 Knee joint endoprosthesis
FR2926719B1 (en) 2008-01-30 2010-03-26 Aston Medical Developmemts Ltd COMPOUND COMPRISING A TIBIAL PLUG AND A TIBIAL AND PROSTHETIC INSERT COMPRISING SUCH AN ASSEMBLY
CN101977570B (en) 2008-02-11 2013-08-14 精密技术公司 Knee prosthesis system with slope
US8292965B2 (en) 2008-02-11 2012-10-23 New York University Knee joint with a ramp
EP2254519B1 (en) * 2008-02-18 2015-05-06 Maxx Orthopedics, Inc. Total knee replacement prosthesis
KR20100136449A (en) 2008-02-18 2010-12-28 막스 오소페딕스, 아이엔씨. Total knee replacement prosthesis with high order nurbs surfaces
JP2009245619A (en) 2008-03-28 2009-10-22 Toshiba Corp Coaxial cable connection/phase adjusting device
US7991599B2 (en) 2008-04-09 2011-08-02 Active Implants Corporation Meniscus prosthetic device selection and implantation methods
US8790411B2 (en) 2008-04-17 2014-07-29 Steven L. Mandell Femoral component of an artificial knee joint
US8696755B2 (en) 2008-04-17 2014-04-15 Steven L. Mandell Tibial component of an artificial knee joint
US8377073B2 (en) 2008-04-21 2013-02-19 Ray Wasielewski Method of designing orthopedic implants using in vivo data
FR2932079B1 (en) 2008-06-06 2010-07-30 Michel Bercovy TOTAL KNEE PROSTHESIS
CN100581490C (en) 2008-06-20 2010-01-20 周一新 Knee-joint prosthesis implantation process, osteotomy module thereof and device thereof
US8298288B2 (en) 2008-06-24 2012-10-30 New York University Recess-ramp knee joint prosthesis
US8206451B2 (en) 2008-06-30 2012-06-26 Depuy Products, Inc. Posterior stabilized orthopaedic prosthesis
US8236061B2 (en) 2008-06-30 2012-08-07 Depuy Products, Inc. Orthopaedic knee prosthesis having controlled condylar curvature
US8075626B2 (en) 2008-06-30 2011-12-13 Depuy Products, Inc. Orthopaedic knee prosthesis having increased axial-rotation
US8187335B2 (en) 2008-06-30 2012-05-29 Depuy Products, Inc. Posterior stabilized orthopaedic knee prosthesis having controlled condylar curvature
US8480752B2 (en) 2008-06-30 2013-07-09 DePuy Synthes Products, LLC Tibial bearing having increased axial-rotation
US8414592B2 (en) 2008-07-11 2013-04-09 Q-Spine, Llc Spinal measuring device and distractor
US8202323B2 (en) 2008-07-16 2012-06-19 Depuy Products, Inc. Knee prostheses with enhanced kinematics
US7981159B2 (en) 2008-07-16 2011-07-19 Depuy Products, Inc. Antero-posterior placement of axis of rotation for a rotating platform
US8715358B2 (en) 2008-07-18 2014-05-06 Michael A. Masini PCL retaining ACL substituting TKA apparatus and method
JP2012500667A (en) 2008-08-20 2012-01-12 シンバシブ テクノロジー インコーポレイティッド Force sensing method for partial and total knee arthroplasty
EP2158879A1 (en) 2008-09-01 2010-03-03 MMK Consulting GmbH Trial Prosthesis for total knee arthroplasty
US8078440B2 (en) 2008-09-19 2011-12-13 Smith & Nephew, Inc. Operatively tuning implants for increased performance
US8187283B2 (en) 2008-09-30 2012-05-29 Depuy Products, Inc. Reusable orthopaedic instrument having drain holes
US8012216B2 (en) 2008-10-17 2011-09-06 Biomet Manufacturing Corp. High flexion tibial tray
US20100100191A1 (en) 2008-10-17 2010-04-22 Biomet Manufacturing Corp. Tibial Tray Having a Reinforcing Member
US20100198275A1 (en) 2008-10-30 2010-08-05 Synvavise Technology, Inc. Force sensing distal femoral alignment system and method of use
US9211189B2 (en) 2008-11-14 2015-12-15 Zimmer, Inc. Transiently mobile tibial engagement
TWM357975U (en) 2008-12-17 2009-06-01 United Orthopedic Corp Structure improvement of orthopedic implant
EP2395947A1 (en) 2009-01-28 2011-12-21 Zimmer, Inc. Lateral condyle with posteriorly located inflection point for total knee implant
JP5419490B2 (en) 2009-02-20 2014-02-19 京セラメディカル株式会社 Artificial knee joint
US8556830B2 (en) 2009-03-31 2013-10-15 Depuy Device and method for displaying joint force data
US8597210B2 (en) * 2009-03-31 2013-12-03 Depuy (Ireland) System and method for displaying joint force data
US8721568B2 (en) 2009-03-31 2014-05-13 Depuy (Ireland) Method for performing an orthopaedic surgical procedure
US8915965B2 (en) 2009-05-07 2014-12-23 Depuy (Ireland) Anterior stabilized knee implant
US20100331733A1 (en) 2009-06-30 2010-12-30 Orthosensor Sensing device and method for an orthopedic joint
US10307256B2 (en) 2009-07-27 2019-06-04 Biomet Manufacturing, Llc Knee replacement system and method for enabling natural knee movement
US8906105B2 (en) 2009-08-11 2014-12-09 Michael D. Ries Systems and methods for mobile bearing prosthetic knee
US8740984B2 (en) 2009-10-06 2014-06-03 Microport Orthopedics Holdings Inc. Tibial implant base
GB2474242B (en) 2009-10-07 2015-08-12 Otis Biotech Co Ltd Artificial knee joint
CA2778040A1 (en) 2009-10-23 2011-04-28 Synvasive Technology, Inc. Knee balancing for revision procedures
EP2319460A1 (en) 2009-10-30 2011-05-11 DePuy Products, Inc. Prosthesis with cut-off pegs
ES2459718T3 (en) 2009-10-30 2014-05-12 Depuy (Ireland) Cementless fixation prosthesis
US8596068B2 (en) 2009-10-30 2013-12-03 Gilbert Staffend High efficiency thermodynamic system
WO2011063123A2 (en) 2009-11-19 2011-05-26 Medicinelodge, Inc. Dba Imds Co-Innovation Articulating and position adjustable trial systems for prosthetic implants
CN102917670B (en) 2009-12-09 2016-08-03 马萨诸塞总医院运营总医院公司 For recovering normal bending range and the implant of motion of knee joint performance
EP2509539B1 (en) 2009-12-11 2020-07-01 ConforMIS, Inc. Patient-specific and patient-engineered orthopedic implants
US9011547B2 (en) 2010-01-21 2015-04-21 Depuy (Ireland) Knee prosthesis system
GB201004068D0 (en) 2010-03-11 2010-04-28 Goodfellow John Tibial prosthetic component for a partial or unicondylar meniscal bearing knee replacement,method of selecting such a tibial prosthetic component
US20130079671A1 (en) 2011-09-23 2013-03-28 Orthosensor Self-contained muscular-skeletal parameter measurement system having shims to adjust height
US9132014B2 (en) 2010-04-13 2015-09-15 Zimmer, Inc. Anterior cruciate ligament substituting knee implants
AU2011240787A1 (en) 2010-04-13 2012-10-25 Smith & Nephew, Inc. Systems and methods for tensioning ligaments and other soft tissues
GB201011448D0 (en) 2010-07-07 2010-08-25 Depuy Ireland A surgical instrument
JP5702467B2 (en) 2010-07-24 2015-04-15 ジンマー,インコーポレイティド Artificial tibia
CA2806326C (en) 2010-07-24 2020-01-07 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US8764840B2 (en) 2010-07-24 2014-07-01 Zimmer, Inc. Tibial prosthesis
JP5642878B2 (en) 2010-08-13 2014-12-17 ジョンソン・エンド・ジョンソン株式会社 Real-time knee balancer
EP2613739B1 (en) 2010-09-10 2017-06-07 Zimmer, Inc. Motion facilitating tibial components for a knee prosthesis
US9597090B2 (en) 2010-12-17 2017-03-21 Zimmer, Inc. Cut guide attachment for use in tibial prosthesis systems
US8603101B2 (en) 2010-12-17 2013-12-10 Zimmer, Inc. Provisional tibial prosthesis system
US20120185054A1 (en) 2011-01-19 2012-07-19 Wright Medical Technology, Inc. Medial pivot posterior stabilized knee implant system
EP2754419B1 (en) 2011-02-15 2024-02-07 ConforMIS, Inc. Patient-adapted and improved orthopedic implants
JP2012240406A (en) 2011-05-24 2012-12-10 Pilot Corporation Shaking-out type mechanical pencil
US8979847B2 (en) 2011-06-06 2015-03-17 Biomet Manufacturing, Llc Method and apparatus for implanting a knee prosthesis
US9060868B2 (en) 2011-06-16 2015-06-23 Zimmer, Inc. Femoral component for a knee prosthesis with bone compacting ridge
US8932365B2 (en) 2011-06-16 2015-01-13 Zimmer, Inc. Femoral component for a knee prosthesis with improved articular characteristics
WO2013013094A1 (en) 2011-07-19 2013-01-24 Zimmer, Inc. Knee arthroplasty instrument
EP2775966B1 (en) 2011-10-24 2015-09-16 Synvasive Technology, Inc. Knee balancing systems
US8858643B2 (en) 2011-11-18 2014-10-14 Zimmer, Inc. Tibial bearing component for a knee prosthesis with improved articular characteristics
ES2585838T3 (en) 2011-11-21 2016-10-10 Zimmer, Inc. Tibial base plate with asymmetric placement of fixing structures
US8911501B2 (en) 2011-12-29 2014-12-16 Mako Surgical Corp. Cruciate-retaining tibial prosthesis
CA2863375C (en) 2012-01-30 2019-07-16 Mary S.S. Wentorf Asymmetric tibial components for a knee prosthesis
US9492290B2 (en) 2012-03-30 2016-11-15 Zimmer, Inc. Tibial prosthesis systems, kits, and methods
US9592133B2 (en) 2013-09-23 2017-03-14 Zimmer, Inc. Spacer block
EP2918235B1 (en) 2013-10-25 2017-01-04 Zimmer, Inc. Cut guide attachment for use in tibial prosthesis systems
WO2017053196A1 (en) 2015-09-21 2017-03-30 Zimmer, Inc. Prosthesis system including tibial bearing component

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5395401A (en) * 1991-06-17 1995-03-07 Bahler; Andre Prosthetic device for a complex joint
US5782925A (en) * 1997-11-06 1998-07-21 Howmedica Inc. Knee implant rotational alignment apparatus
EP1132063A2 (en) * 2000-03-08 2001-09-12 Biomedical Engineering Trust Posterior stabilized knee replacement with dislocation prevention features
US7850698B2 (en) 2005-02-17 2010-12-14 Zimmer Technology, Inc. Tibial trialing assembly and method of trialing a tibial implant
US20070239165A1 (en) * 2006-03-29 2007-10-11 Farid Amirouche Device and method of spacer and trial design during joint arthroplasty
US20090125114A1 (en) * 2007-10-10 2009-05-14 Biomet Manufacturing Corp. Knee joint prosthesis system and method for implantation

Cited By (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10195041B2 (en) 2010-07-24 2019-02-05 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US11224519B2 (en) 2010-07-24 2022-01-18 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US10543099B2 (en) 2010-07-24 2020-01-28 Zimmer, Inc. Tibial prosthesis
US10470889B2 (en) 2010-07-24 2019-11-12 Zimmer, Inc. Asymmetric tibial components for a knee prosthesis
US11471288B2 (en) 2010-09-10 2022-10-18 Zimmer, Inc. Motion facilitating tibial components for a knee prosthesis
US10413415B2 (en) 2010-09-10 2019-09-17 Zimmer, Inc. Motion facilitating tibial components for a knee prosthesis
US10010330B2 (en) 2010-12-17 2018-07-03 Zimmer, Inc. Cut guide attachment for use in tibial prosthesis systems
US9763807B2 (en) 2010-12-17 2017-09-19 Zimmer, Inc. Provisional tibial prosthesis system
US10188530B2 (en) 2010-12-17 2019-01-29 Zimmer, Inc. Provisional tibial prosthesis system
US10898337B2 (en) 2011-11-18 2021-01-26 Zimmer, Inc. Tibial bearing component for a knee prosthesis with improved articular characteristics
US10265181B2 (en) 2011-11-21 2019-04-23 Zimmer, Inc. Tibial baseplate with asymmetric placement of fixation structures
EP2830543A1 (en) * 2012-03-30 2015-02-04 Zimmer, Inc. Tibial prosthesis systems, kits, and methods
EP2830543B1 (en) * 2012-03-30 2017-11-01 Zimmer, Inc. Tibial prosthesis systems
JP2015533608A (en) * 2012-11-07 2015-11-26 ウク カン,ヒョン Femoral component for femoral knee implant system
US11324598B2 (en) 2013-08-30 2022-05-10 Zimmer, Inc. Method for optimizing implant designs
US9901331B2 (en) 2013-09-23 2018-02-27 Zimmer, Inc. Spacer block
WO2016026007A1 (en) * 2014-08-21 2016-02-25 Hoe Frederick Knee prosthesis apparatus and methods and instrumentation for implantation thereof
US10278827B2 (en) 2015-09-21 2019-05-07 Zimmer, Inc. Prosthesis system including tibial bearing component
US11160659B2 (en) 2015-09-21 2021-11-02 Zimmer, Inc. Prosthesis system including tibial bearing component
US10987232B2 (en) 2016-09-28 2021-04-27 Kyocera Corporation Artificial knee joint replacement operation instrument
US10675153B2 (en) 2017-03-10 2020-06-09 Zimmer, Inc. Tibial prosthesis with tibial bearing component securing feature
US11547571B2 (en) 2017-03-10 2023-01-10 Zimmer, Inc. Tibial prosthesis with tibial bearing component securing feature
US11324599B2 (en) 2017-05-12 2022-05-10 Zimmer, Inc. Femoral prostheses with upsizing and downsizing capabilities
US11426282B2 (en) 2017-11-16 2022-08-30 Zimmer, Inc. Implants for adding joint inclination to a knee arthroplasty
US10835380B2 (en) 2018-04-30 2020-11-17 Zimmer, Inc. Posterior stabilized prosthesis system
US11911279B2 (en) 2018-04-30 2024-02-27 Zimmer, Inc. Posterior stabilized prosthesis system
US11633294B2 (en) 2019-12-09 2023-04-25 Depuy Ireland Unlimited Company Orthopaedic surgical instrument system having an anterior-loading tibial bearing trial and associated surgical method of using the same

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